Medical care organization for older patients in geriatric centers is of particular interest due to the increase proportion of older population in Russian Federation. Geriatric patients experience cognitive, neurological, sensory changes, including decreased vision, hearing, rate of reaction, as well as increased time for assimilation of new information. Patients with age-related characteristics may encounter various problems during examination in radiology departments. This article presents methodological recommendations for examination of older patients based on personal experience and analyzed literature.

Grounded in attitude to ethnicity, gender, health, age and other social variables social stigmatization is deeply entrenched in today's society. In the light of increasing life expectancy and changing in age structure of the population, the problem of gerontological ageism seems to be relevant. The negative view of the anthropometric, cognitive, physical characteristics of the older adults is acceptable to society thus adversely affecting their quality of life and secondarily reinforcing undesirable patterns. The paper outlines the basic ideas about this phenomenon, psychological and social determinants, research data, diagnostic methods, as well as possible ways to overcome the problem. An important task for gerontological specialists is educational work at all stages of interaction with older patients and their accompanying persons.

Age-associated processes combined with comorbidity affect the physiological reserves of patients of older age groups, having a negative impact on the surgery and the postoperative period. One of the most important geriatric syndromes, closely related to the treatment outcome in patients over 60, is frailty. The prevalence of frailty increases with age, and that is associated with a worsening of the perioperative prognosis, prolonged hospitalization, and an increase in mortality. The methods widely used for perioperative risk stratification do not take into account the presence and severity of frailty, changes in the functional state and reserve capabilities of the body, which reduces their sensitivity for patients of older age groups. The article considers the generally accepted approaches to risk stratification and identifies further development prospects in this area.

Approximately 6 thousand endoprosthesis surgeries of hip, knee and spine stabilization are annually performed in older patients in the Irkutsk region. Patients require a second stage of medical rehabilitation — in a specialized rehabilitation unit. The article presents the technology of medical rehabilitation, which is used for this group of patients, including assessment of rehabilitation prognosis, application of physical rehabilitation methods, correction of somatic pathology and psychological status.
Aim: to improve the immediate and long-term results of hip and knee endoprosthetics, spine stabilization surgeries by developing a system of rehabilitation measures based on individual patient parameters and aimed at optimal restoration of function.
Materials and Methods. The focus of the investigation was on the patients from the Medical Rehabilitation Department, Clinical Hospital of the ISC SB of the RAS. Patients affected with coxarthrosis, gonarthritis, osteochondrosis of the spine, who had undergone joint replacement or stabilizing spinal surgery in the Medical Rehabilitation Department of Irkutsk Scientific Center of Surgery and Traumatology, 5–7 days before transfer to the Medical Rehabilitation Department of Clinical Hospital of the ISC SB of the RAS. The subjects also underwent clinical, paraclinical, locomotive, physical examination and laboratory test; physical activity assessment and estimation of indicators of the integral rehabilitation scale, the medical rehabilitation scale and the physical activity scale were performed as well. In the course of medical rehabilitation, patients received physiotherapeutic appointments, physiotherapy exercises, correction of somatic pathology, and correction of psychological status.
Results. In 2020–2021, 240 older patients were treated in the Medical Rehabilitation Department after large joints arthroplasty and spinal reconstructive surgeries. The technology of medical rehabilitation was used for these patients. As a result, pain syndrome was eliminated, contracture of the operated joint was stopped, locomotor function improved, patients' physical activity and self-care ability were optimized, and somatic disorders were corrected. In addition, our own scales have been developed and improved: the Integral Rehabilitation Orthopedic Scale, the Individual Physical Activity Scale.
Conclusion. Implementation of this rehabilitation technology has significantly optimized the outcomes of large joints arthroplasty or spinal reconstructive surgeries.

Older inpatient with diabetes mellitus is highly vulnerable to acute diabetes complications. Awareness-raising program for nursing staff is aimed to shed the light on risk factors and thereby reduce diabetic complications frequency, and to implement clear algorithm of actions to cope complications when they occur minimize consequences for the patient and the clinic.

Background. Prevention of the diseases is the cornerstone of medicine. Preventing of the diseases improves the quality and life expectancy, and also reduces the costs for the diagnosis and treatment of diseases. The main preventive measures include maintaining a healthy lifestyle (proper nutrition and regular exercise) and vaccination.
Purpose: to study the influence of distance learning programs on the knowledge of doctors about the vaccination.
Materials and methods: a distance learning cycle of lectures was conducted on the vaccination of elderly patients. Before and after the course of lectures, an anonymous voluntary survey of the course participants was conducted. The questionnaires included questions for free completion, questions for assessing attitudes on a scale from 0 to 10 (where 0 strongly disagree and 10 strongly agree) and multiple choices questions. Physicians were informed before the survey that the data would be subsequently analyzed and published.
Results: 556 people took part in the first stage of the survey, of which 469 (84.3%) were women. 328 people took part in the second stage of the survey, of which 271 (82.6%) were women. The experience of doctors was on average 27±11,8 years, specialists from 72 specialties took part. Before the course of the lecture, on average, the opinion of doctors on vaccination was 8.7±0.1 out of 10, after the course of the lecture it became 9.1±0.1 out of 10 (p < 0.05). Before the start of the course, on average, doctors assessed their knowledge at 6.9±0.1, after the end of the course 7.7±0.1 (p < 0.05). After a course of lectures, 95% of the respondents answered that they would recommend vaccination to their older patients and relatives.
Conclusion: on-line learning course of lectures has been shown to be an effective method of improving the quality of doctors' knowledge about the importance and safety of vaccination of people of older and senile age.