Cardiovascular disease is  the leading cause of  morbidity and mortality, especially in  older adults. The older are characterized by a combination of CVD with other non-infection chronic diseases, changes in cognitive and functional status, social and economic circumstances. To  date, there are no  formalized guidelines for managing patients in response to all issues, since historically clinical recommendations are «disease-centric», while older patients with CVD require an inclusive and integrative patient-centric approach to insure comprehensive health care. Integration of the basic principles of cardiovascular disease management and the principles of geriatrics is becoming increasingly necessary to provide high quality care for older patients.

A fall is defined as an event, which results in a person coming to rest inadvertently on the ground or floor or other lower level, except in cases, which are the result of a blow, loss of consciousness, sudden paralysis or an epilepsy [1]. Falls and fear of falling cause serious health problems, which, in turn are associated with high injury rate, high medical costs and a negative impact on quality of life. Older and senile patients with cardiovascular disease (CVD) are at high risk of falling. However, in clinical practice, the prevalence of falls and the risks of falls are not well understood and underestimated by physicians and patients themselves. An increased risk of falling is associated with various factors, such as drugs, structural heart disease, orthostatic hypotension and arrhythmias, as well as gait and balance disorders, physical weakness, sensory disturbances. These risks are especially important with the growing number of older people with cardiovascular disease. All physicians involved in  the care of  patients with CVD should pay attention to  the assessment, prevention and treatment of falls in adults with heart disease, and the treatment of cardiovascular disease in patients at risk of falls.

Adequate nutrition with a high protein content is one of the main conditions in the complex treatment of sarcopenia. This review article considers strategies for maintaining the dietary derived protein and amino acids value in patients with sarcopenia. The features of  nutritious diet in  young, middle-aged and older people including those with sarcopenia are compared and outlined. The possibilities of nutritional supplements of proteins and amino acids in the diet of geriatric patients with sarcopenia are given.

The review analyzes studies on  the efficacy and safety of  reperfusion therapy for ST-segment elevation myocardial infarction in patients over 75 years of age. Registers data on the positive impact of reperfusion treatments on outcomes in older patients hospitalized with STEMI are given. Particular emphasis is put on the need for prospective studies to determine the optimal tactics for managing older and oldest older patients with STEMI.

Cardiopulmonary exercise testing is  a study that provides both prognostic and diagnostic information about the state of the cardiovascular, respiratory systems and metabolic processes allowing us to determine how these systems contribute to a decrease in exercise tolerance. A large number of clinical studies using this method have shown its safety and diagnostic value. However, due to  insufficient education among doctors and little experience, CPNT is currently not widely used in diagnostics, especially in the geriatrics. This review of available literature over the last 10 years is devoted to the relevance of the use of cardiopulmonary exercise testing in older and oldest older patients, the essence and methodology of the study, possible changes in indicators in patients with frailty, chronic heart failure, and diseases of the bronchopulmonary system.

Background: GR  with implementation of  additional geriatric rehabilitation stage has been shown in  a number of  studies to  be efficient in  daily functional activities as  well as  in reducing hospital readmissions and mortality. However, better integration of geriatric care models into clinical practice requires further investigations.

Aim: to assess the influence of geriatric rehabilitation on functional activity.

Methods: рrotocol POSTSCRIPTUM suggests Multicentral Prospective Study on  different protocols for Geriatric Rehabilitationл in Moscow boarding houses or nursing homes. The study consists of 21-days period of active treatment based on the results of complex geriatric assessment and 12-months follow-up period. The study enrolls patients aged 60 years and older, who have indications for geriatric rehabilitation.

Conclusion: POSTSCRIPTUM — the 1st Russian study on efficacy of geriatric rehabilitation programs that based on complex geriatric assessment.

Heart failure is one of the most common cardiovascular conditions with a steadily increasing incidence. Management of  such patients only by  general practitioners and cardiologists make it  impossible to  provide high-quality medical care. To ensure multidisciplinary monitoring of heart failure patients in many countries, including Russia, heart failure clinics are actively developing. Specially trained nursing staff play a particular role in the implementation of the clinics’ purposes. Working at Heart Failure Clinic requires advanced training, which in turn determines the priority for the development of  new educational programs and expanding the competencies of  nursing staff in  our country. This article describes the foreign experience of nursing staff in outpatient monitoring of patients with heart failure.

Syncope is a short-term transient loss of consciousness associated with a decrease or cessation of blood supply to the brain. Syncope is one of the causes of falls in older patients, leading to increased hospitalizations and deaths. There is  an  increased  susceptibility to  syncope  with advancing  age and sometimes it  occurs with no  identifiable cause. Orthostatic hypotension, carotid sinus syndrome, neuromediated syncope, structural heart disease, and cardiac arrhythmias are the common contributors to  syncope in  older adults. Given the high risk in  this group of  patients, a structured and integrated approach to the management of older patient with syncope is required. Implementing the algorithm for the management of such patients allows us to evaluate the syncope cause, assess the risk and choose the optimal treatment for older patients.