The prevalence of  chronic kidney disease (CKD) increases with age, but CKD is  often underdiagnosed in  older adults and regarded as  age-related changes of  kidney function. Screening for CKD is  mandatory in  older adults and should include estimated glomerular filtration rate (eGFR) using both the CKD EPI creatinine-based formula and the albumin/creatinine ratio in a urine spot sample. In older adults the diagnostic criteria of CKD are the same as in younger subjects.  CKD is  associated with advanced ageing and requires careful assessment of  geriatric syndromes.  Renal function should be assessed at least annually, considering a rate of decline in eGFR greater than 1 ml/min/1.73 m² per year as significant. Older adults with CKD are characterized by high comorbidity; risk factors for CKD and geriatric syndromes overlap. CKD should be  considered among a  number of  comorbid conditions that increase the risk of  deterioration of  geriatric status and underline the need for multidisciplinary management based on a comprehensive geriatric assessment. Patients with eGFR <60 ml/min/1.73 m² should be considered at high risk for renal and extrarenal adverse drug effects. In these patients, inappropriate medications, supplements, and vitamins should be carefully identified and corrected using STOPP/START criteria. eGFR and estimated creatinine clearance should be  carefully monitored during treatment with drugs that can potentially affect renal function and/or the dose of which is adjusted based on renal function, as well as during acute illness or exacerbation of chronic conditions.

Background. The trend towards aging of  the population is  global, which makes the study of  etiology, prevention and treatment of  age-related disorders relevant. Increasing number of  studies highlights the influence of  25-hydroxyvitamin D deficiency on health state in older people, as well as its correlation with geriatric syndromes prevalence. However, at the moment it is not known whether these patterns persist in patients older than 90 due to the limited number of studies on this population.

Aim. To assess the prevalence of vitamin D deficiency in a cohort of centenarians in the central region of Russian Federation and to study its relationship with the presence of geriatric syndromes.

Materials and methods. The study was carried out by Russian Gerontology Research and Clinical Centre of  Pirogov Russian National Research Medical University and Center for Strategic Planning and Management of  Medical and Biological Health Risks. It was a cross-sectional study on the cohort of centenarians (90 years and older). Complex geriatric assessment was performed. Complex geriatric assessment included past medical history, geriatric scales and questionnaires (MMSE, SARC-F, MNA scores). Blood samples were taken to assess the 25-OH vitamin D levels using chemiluminescence method. The study is  reviewed by  the ethics committee (№ 30 24.12.2019). The statistical analysis was performed using Python version 3.9 and R version 4.1.3.

Results. The study included 3,235 people aged 90 to 107 years. Median level of 25-hydroxyvitamin D was 9 ng/ml, 86.7% of participants were found to be 25(OH)D deficient, and in 8.3% insufficiency 25(OH)D was detected. Using the intergroup analysis, the association between 25-OH vitamin D levels and some geriatric syndromes, such as malnutrition, sarcopenia and cognitive impairment was observed. However, after adjusting to physical activity and nutrition statistically significant association was demonstrated only for cognitive impairment.

Conclusion. The results obtained on the association between low levels of 25-OH vitamin D and cognitive impairment among centenarians confirm the importance of  vitamin D  deficiency prevention and might be  starting point for future studies.

Currently, the world is experiencing a steady increase in the number of patients with type 2 diabetes mellitus (T2DM); this disease is recognized as a global medical and social problem of the 21st century. There is also a trend towards increasing life expectancy and, as a result, an aging population. Accordingly, the number of older patients with T2DM is increasing. Hypoglycemia, a  serious complication of  T2DM, is  quite common among this category of  patients. Hypoglycemia leads to worsening glycemic control, cognitive deficits, and an increased risk of adverse cardiovascular outcomes in older patients. This review examines the risk factors for hypoglycemic conditions that must be  taken into account when prescribing glucose-lowering therapy to  older patients and their prognostic significance in  assessing the risk of  hypoglycemia. The possible negative consequences of hypoglycemia are described and the importance of individual goals for glycemic control in older patients is emphasized.

The  impact  of  aging and geriatric syndromes on  chronic obstructive pulmonary disease, a  complex, chronic inflammatory condition, is a subject of significant interest in aging medicine. Understanding the key pathogenic mechanisms that combine the aging process and chronic obstructive pulmonary disease can help rethink therapeutic concepts in patients with the described comorbidity and be considered the basis of new directions for preventive measures.The purpose of the review is to update data from open access scientific sources on the pathogenetic mechanisms and clinical relationships of chronic obstructive pulmonary disease, sarcopenia, and frailty.

Methods. Foreign and domestic scientific publications on this topic over the past 15 years were analyzed using electronic libraries PubMed/MedLine, Elsevier, elibrary.

Conclusion. An  extensive examination  of  current scientific data  was carried out to  determine the pathogenetic connections between chronic obstructive pulmonary disease and the aging process, along with the prominent geriatric conditions of sarcopenia and frailty. A significant amount of information has been accumulated indicating deterioration in the clinical manifestations and prognosis of older patients with a combination of the described pathologies; therefore, the relevance of further study of these comorbidities remains. The cause-and-effect relationship of these clinical manifestations remains not entirely clear: chronic obstructive pulmonary disease leads to  the development of  sarcopenia and frailty, or  these geriatric syndromes only accompany chronic obstructive pulmonary disease, as  a disease that manifests itself most frequently in advanced age. There is significant interest in developing therapeutic strategies to improve the clinical outcomes of older patients with a combination of chronic obstructive pulmonary disease, frailty and sarcopenia.

The focus of  this article is  on  cerebral  microangiopathy (CMA), also known as  cerebral small vessel disease, which is commonly linked to age and vascular risk factors. It is a major contributor to both vascular and mixed cognitive decline in  older individuals. The leading causes of  vascular cognitive impairment and dementia include hypertension, high cholesterol, type 2 diabetes mellitus, smoking, and atrial fibrillation. The main manifestations of CMA in patients over 60 are outlined in this article, with supporting evidence from both domestic and foreign studies. By examining a specific clinical case, the characteristics, diagnosis, and treatment of cognitive impairment caused by CMA and vascular risk factors in an older patient were analyzed.