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Russian Journal of Geriatric Medicine

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No 2 (2025)
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EDITOR’S LETTER

MAIN TOPIC

90-114 816
Abstract

This consensus was prepared by a group of experts from various specialties in the interests of improving the quality of specialized medical care for elderly and old age patients with hip fractures, which are almost always the result of osteoporosis and an increased risk of falls. Difficulties in the treatment of this category of patients are due to both the severity of the injury itself and comorbidity, which is accompanied by high mortality and extremely low quality of life for survivors. Effective management of such patients is possible only with the joint involvement of doctors and nurses of surgical and internal medicine and geriatric profiles within the framework of the so-called orthogeriatric approach. Experts in the field of traumatology and orthopedics, anesthesiology and intensive care, geriatrics, rehabilitation, clinical pharmacology, therapy, rheumatology and endocrinology based on the available clinical recommendations and orders of the Ministry of Health Care of the Russian Federation, literature data and general discussion formulated the basic principles of interdisciplinary management of elderly and senile people with hip fracture. The aim of the consensus is to help establishing effective interaction between professionals of different specialties based on their better mutual understanding, which will contribute to improving specialized medical care, saving lives and reducing disability of elderly patients with hip fracture.

REVIEWS

115-124 2016
Abstract

Osteoporosis is a systemic metabolic bone disease characterized by progressive loss of bone mineral density (BMD) and deterioration of bone microarchitecture, leading to increased bone fragility and susceptibility to low-energy fractures. This condition is of particular concern in geriatric populations, where its prevalence reaches critical levels. Epidemiological studies indicate that osteoporosis affects one in three women and one in five men over 65 years of age, representing a significant medical and socioeconomic burden. The clinical significance of osteoporosis stems from its severe complications, including chronic pain syndrome, profound mobility limitations, reduced quality of life, and increased risks of disability and mortality (particularly following hip fractures). Consequently, developing effective treatment and prevention strategies for osteoporosis in elderly and senile patients remains a priority in modern gerontology and osteology. Contemporary pharmacological approaches to osteoporosis management include antiresorptive (bisphosphonates, denosumab) and anabolic (teriparatide, romosozumab) agents, with treatment selection requiring careful consideration of age-related factors, comorbidities, and individual fracture risk profiles. This review synthesizes current evidence on pharmacological interventions for osteoporosis in geriatric practice, including emerging therapeutic strategies and future treatment directions.

125-144 1156
Abstract

The clinical guidelines reflect the features of osteoarthritis management in elderly patients. The high prevalence of comorbidity in this category of patients, the relationship between osteoarthritis and geriatric syndromes, such as frailty and sarcopenia, are discussed. The high prevalence of neuropathic pain in elderly patients with osteoarthritis is emphasized. All these features suggest optimization of non- and drug therapy.

Theses for the I Forum «Longevity Technologies»

145-146 777
Abstract

TOPICALITY. It is known that diseases of the gastrointestinal tract are widespread, especially among the elderly. This is due to degenerative functional changes in the digestive system, concomitant pathology, requiring the intake of constant drug therapy. Chronic duodenal insufficiency (CDI) is a syndrome characterized by complex morphofunctional changes in the duodenum. To date, there are practically no data on the peculiarities of the clinical picture of CDI in elderly patients.

147-149 777
Abstract

RELEVANCE. The mental disorders in the elderly are an urgent topic, as they are promoted by vascular diseases, neuron death and degenerative-dystrophic changes in the cerebral cortex. They are characterized by a wide range of manifestations and are sometimes detected late. Often, the versatility and unpredictability of their manifestations causes practitioners great difficulties in timely diagnosis and treatment tactics.

150-155 759
Abstract

TOPICALITY. In the middle of the last century, only about 8 % of the world's population was aged 60 or older. By 2000, this number had increased to 10 %; according to clinical and epidemiological studies, this figure is expected to reach 21 % by 2050. In recent years, there has been a steady trend towards an increase in the share of older people in Russian society. On the other hand, both on the part of the state and people of older age groups themselves, there is an increased demand for their social involvement [1]. One of the keys to the success of this engagement is to improve the quality of life related to health, and its main feature is functionality [2]. On the other hand, functionality itself is an important component of geriatric assessment, especially in light of the implementation of geriatric prevention programs. Functionality is an important component of geriatric assessment [3].

Providing comprehensive clinical prevention services for this population is important; however, individuals over 65 years of age are rarely included in prevention studies. But behavior, functional status, comorbidities, and life expectancy can predict who will benefit most from geriatric screening and preventive care. One of the keys to successful involvement of older people is to improve the quality of life related to health, and its main feature is functionality [4]. On the other hand, functionality itself is an important component of geriatric assessment [5]. Studies show that older adults with good functional status and no comorbidities are in the upper quartile (75th percentile) of life expectancy, whereas individuals with significant comorbidities and functional impairments are shown to be in the lower quartile (25th percentile) of life expectancy. [6]

156-158 742
Abstract

ACTUALITY. Geriatric syndromes affect the course of chronic diseases. One of the confirmations of this is the frequent detection of sarcopenia in elderly people suffering from type 2nd diabetes. This is directly related to the progression of polyneuropathy, as there is a decrease in muscle strength of the lower extremities. In this paper, we studied the relationship between the development of sarcopenia with the presence and progression of diabetic polyneuropathy in older patients. Early detection of geriatric syndromes in patients leads to multifactorial disease control, which increases the duration and quality of life of older patients.

159-160 740
Abstract

ACTUALITY. The topic discussed is of special significance, as the chronic heart failure is an urgent problem for cardiologists, therapists and geriatricians because of its symptoms versatility or even their absence accompanied by iron deficiency.

161-163 840
Abstract

INTRODUCTION. One of the key processes that inevitably accompany aging is considered to be a variety of changes in body composition. As we age, lean tissue components (in particular, skeletal muscles) decrease, while the content of adipose tissue increases. Progressive and generalized loss of skeletal muscle mass, strength or function (sarcopenia) leads to various adverse outcomes, including disability, deterioration in quality of life, and death. The SARC-F questionnaire is used for screening diagnostics of sarcopenia. A decrease in muscle mass is determined using dual-energy X-ray absorptiometry or bioimpedance analysis. However, the interchangeability of these methods requires clarification.

164-166 787
Abstract

INTRODUCTION. Vitamin D is primarily known for its effects on the regulation of calcium homeostasis and bone metabolism, but its receptors have been found in more than 30 human organs and tissues, including the nervous system. Vitamin D deficiency is associated with various diseases, but its role in the formation of extraskeletal pathological conditions requires clarification.

167-169 734
Abstract

RELEVANCE. The implementation of the national project "Prolonged and Active Life" is one of the priority tasks of the Russian Federation's state social policy, with a key focus on improving geriatric and gerontological care. In this context, enhancing the competence of all professionals working with elderly individuals is of paramount importance. However, practical experience indicates that gerontological ageism remains a frequent issue encountered by elderly patients in medical and social institutions. Consequently, gerontological education, which encompasses an understanding of the natural processes of aging, ethical and deontological attitudes towards the elderly, and the development of gerontological competence, should be integrated into the curriculum of medical universities at the earliest stages of training.

170-171 729
Abstract

BACKGROUND. Sarcopenic obesity is a clinical condition characterized by a combination of excess body weight and a decrease in muscle mass and strength. This condition leads to reduced physical functionality and increased risk of disability in older adults. Despite its impact on quality of life and prognosis, the diagnosis and management of sarcopenic obesity remain challenging in geriatric practice. Studying the clinical characteristics of these patients can contribute to the development of more effective strategies for their care.

172-174 714
Abstract

Background. The search for an optimal model of support and assistance to the aging population is underway in all countries of the world. Patients of older age groups constitute a special category of citizens, who are characterized by a potentially high level of comorbidity, which affects the formation of frailty and other geriatric syndromes. Elderly people with polymorbid pathology often have low functional activity, cognitive impairment, and depression. These are “fragile” patients with a reduced quality of life and frequent hospitalizations. As part of the development of a long-term care system (LTCS) for “fragile” patients and the introduction of innovative gerontotechnologies, since 2018, a scientific and practical project “Care and Nursing for the Older Generation!” has been implemented in St. Petersburg and the Leningrad Region. The project was initiated by the Scientific and Innovation Center “Professional Longevity” to expand the range of services in the field of social and medical care within the framework of the LTCS, improve the quality of life and extend the period of active longevity of geriatric patients.

175-177 707
Abstract

Background. It has been established that senile xerosis or “fragility” of the skin occurs in 75 % of the population over 65 years of age, when pathological skin dryness leads to peeling, the formation of microcracks, the appearance of senile itching, sleep disorders, the development of pressure sores and, as a result, decreased physical activity. According to the British authors, bedsores are formed in 15–20 % of patients in medical and preventive care facilities. Adequate prevention of pressure sores prevents their development in patients at risk in more than 80 % of cases, which allows not only to reduce the financial costs of bedsores treatment, but also to improve the patient’s quality of life. The risk assessment of the pressure sores development, as a rule, requires expert clinical opinions from qualified medical professionals with experience in managing patients at risk of pressure sores development. An alternative is to use specially designed assessment scales.

178-180 714
Abstract

Background. Multiple comorbid conditions in the geriatric population are associated with changes in the classical clinical picture of diseases and the nature of their course, an increase in the number and severity of complications, a deterioration in quality of life (QL), and a decrease in functional activity. The desire to increase the effectiveness of treatment, to help the patient recover from all the diseases he has, inevitably leads to the appointment of a large number of drugs. The negative consequences of polypragmasia include: an increase in the incidence of adverse drug reactions (ADR), the development of geriatric syndromes, a decrease in the effectiveness of treatment and complianceto it, a decrease in the patient's QL, an increase in the frequency of hospitalizations and mortality due to a decrease in the effectiveness and safety of therapy, and an increase in the cost of treatment. Elderly and senile patients are particularly vulnerable to ADR. Undesirable reactions may occur atypically in them. A strikingexample is the adverse light-dependent skin reactions when taking drugs with the risk of photosensitization.

Photosensitizing substances are drugs that, with resorptive or local action, increase skin sensitivity to sunlight or artificial ultraviolet rays (UVR). Compounds that make the skin hypersensitive to UVR are found in many medications. Once in the body, thesedrugs are converted into various metabolites and accumulate in tissues, and when activated byUVR, cause phototoxic or photoallergic reactions. In response to the effects of a combination of such drugs and UVR, edema, nodules, spots, vesicles, acute eczematous reaction, and urticaria appear. Epithelial desquamation, hyper- and hypopigmentation of the skin are also possible. Hypersensitivity to UVR can persist for several months after the withdrawal of photosensitizing drugs.

181-183 730
Abstract

BACKGROUND. The provision of medical care to community-dwelling older adultswith limited mobility constitutes a significant and socially relevant domain within outpatient medicine. The fact that a substantial number of individuals with restricted mobility are older adults, underscores the importance of implementing comprehensive screening and corrective measures for geriatric syndromes. Such interventions are crucial for optimizing patient outcomes and enhancing overall quality of life.

184-185 1960
Abstract

RELEVANCE. An urgent problem of teaching geriatrics is the search for new forms of educational activity that can interest students and stimulate their cognitive activity.

186-187 685
Abstract

RELEVANCE. The organization of extracurricular work of students is an important task of a university teacher, since the time in the classroom is very limited, and the subject matter is strictly set by the discipline's work program. Extracurricular work allows you to consider issues of personal interest to students, as well as offer new forms of work.

188-189 538
Abstract

BACKGROUND. In the context of the rapid aging of the population in many countries of the world, the relevance of studying intergenerational relations has become particularly important. Older people face the risk of social isolation and ageism, which negatively affects their physical and psycho-emotional state. Establishing and maintaining intergenerational ties is not only a necessity for improving the quality of life of older people, but also an important aspect of social policy aimed at creating a more inclusive and harmonious society.

190-192 544
Abstract

ACTUALITY. One of the most difficult categories of dental patients are elderly people. A large number of symptoms, related or unrelated, and the burdening of general somatic diseases are the factors that determine incorrect or untimely diagnostics, and as a result, treatment of dental diseases.

193-195 533
Abstract

ACTUALITY. Endodontic treatment poses a significant clinical challenge, particularly in cases of calcified root canals (CRCs). Age-related changes in dentin structure, accompanied by partial or complete canal calcification, significantly complicate mechanical instrumentation, irrigation, and obturation of the root canal system. These factors increase the risk of iatrogenic complications and reduce the predictability of successful treatment outcomes. Given the increasing life expectancy and the growing need for geriatric patients to maintain their dentition, investigating effective approaches for managing CRCs in this population is of high relevance to clinical endodontics and geriatric dentistry.

OBJECTIVE. To determine the clinical features of endodontic treatment in geriatric patients with calcified root canals, evaluate the effectiveness of modern instrumental and pharmacological approaches, and identify key factors influencing treatment prognosis. MATERIALS AND METHODS. This clinical study was conducted at the Republican Dental Clinic and involved 72 patients aged 65–85 years diagnosed with calcified root canals based on cone-beam computed tomography (CBCT). The study included patients with vital and non-vital pulp, without significant root resorption or severe systemic diseases affecting bone tissue. Exclusion criteria included uncontrolled diabetes mellitus, severe cardiovascular diseases, and oncological pathology. Diagnostic methods comprised clinical examination, CBCT imaging, and endodontic microscopy. Treatment was performed using ultrasonic activation of irrigants and mechanical preparation with highly flexible nickel-titanium rotary instruments. A 17 % EDTA solution and 5.25 % sodium hypochlorite were used with ultrasonic activation to remove calcifications. The obturation technique involved vertical compaction of warm gutta-percha. Treatment effectiveness was assessed 12 months postoperatively using CBCT and clinical evaluation.

RESULTS. Full canal patency was achieved in 89% of cases (64 out of 72 teeth), while in 11 % (8 cases), calcifications impeded adequate instrumentation, necessitating treatment protocol modifications. The average time required to negotiate calcified root canals was (34.7 ± 5.2) minutes. The use of ultrasonic irrigation activation contributed to more effective calcification removal and a reduced incidence of instrument-related complications. After 12 months, treatment success — confirmed by clinical and radiographic criteria — was observed in 91.6 % of cases. Patients with complete canal patency had significantly better outcomes, whereas partial apical third calcification substantially reduced the likelihood of successful treatment. The primary predictors of treatment failure included significant apical third calcification (which increased failure risk by 4.3 times, p < 0.05), pronounced thinning of canal walls (which elevated the risk of perforation), and the presence of associated periapical lesions.

CONCLUSION. Endodontic treatment of calcified root canals in geriatric patients requires an individualized approach utilizing advanced imaging techniques, flexible instruments, and effective irrigation strategies. Ultrasonic activation of irrigants and the use of highly flexible nickel-titanium instruments enhance treatment success and reduce the risk of complications.

196-198 516
Abstract

RELEVANCE. Peri-implantitis is one of the leading causes of dental implant failure, particularly in elderly patients with impaired osteogenesis. Age-related changes, osteoporosis, osteopenia, and comorbid conditions such as diabetes mellitus and cardiovascular diseases reduce the regenerative potential of bone tissue, complicating the treatment of peri-implantitis. Standard treatment methods for peri-implantitis often prove insufficiently effective, as they do not account for individual variations in bone metabolism. Therefore, the development of personalized approaches based on the assessment of biochemical markers of osteogenesis, radiographic bone density, and systemic risk factors is a crucial objective in modern dentistry.

199-200 523
Abstract

BACKGROUND. Increased life expectancy has led to a rise in the number of elderly patients with polymorbidity and polypharmacy. These factors contribute to the development of caries due to impaired salivation and mineral metabolism. Diseases such as diabetes mellitus, osteoporosis, and cardiovascular pathologies reduce the remineralization potential of enamel. Additionally, many medications (antihypertensive drugs, antidepressants, diuretics) cause xerostomia, creating favorable conditions for the growth of cariogenic microflora. Standard preventive approaches are not sufficiently effective, justifying the need for personalized strategies that consider individual health conditions and medication burden.

201-202 536
Abstract

BACKGROUND.The prevention of many socially significant diseases (osteoporosis, non-communicable diseases) consists in identifying risk factors and early diagnosis of conditions preceding the development of these diseases, that is, the stage of "pre-disease." Therefore, studying the frequency of such geriatric syndromes as osteopenia, sarcopenia, visceral obesity (predictors of osteoporosis,hypertension, coronary heart disease, diabetes mellitus) seems to be an urgent task, especially among pre- and postmenopausal women, contributing to a decrease in bone mineral density (BMD) and a change in body composition (BC) accumulation of fat and loss of muscle mass (MM).

203-205 530
Abstract

RELAVANCE. Early diagnosis of PMR is important, since the duration of treatment and the outcome of the disease depend on it. W. Bruce, 1888 called PMR "prussic rheumatic gout" and only Barber, 1957 ― polymyalgia rheumatica.

206-208 525
Abstract

ACTUALITY. Advanced age and dyslipidemia are major risk factors for cardiovascular diseases (CVD) and mortality. Hypercholesterolemia remains a leading risk factor for ischemic heart disease (IHD) in the elderly. Clinicians often face challenges in selecting optimal preventive measures, medications, and monitoring strategies for older patients.

209-211 658
Abstract

Sarcopenia increases the risk of adverse outcomes in older patients. Loss of muscle mass poses a threat to the functioning, independence and quality of life of an elderly person. It is necessary to determine the importance of clinical and instrumental assessment of the state of muscle tissue in patients with geriatric syndromes for understanding the tactics and diagnostic logistics of a patient with suspected sarcopenia. For this purpose, 156 patients over 60 years of age were examined, each of whom underwent a comprehensive geriatric assessment, wrist dynamometry, a 5-rise test from a chair, a walking speed test, SARC-F questionnaire testing, dual-energy X-ray absorptiometry with determination of muscle mass, and bioimpedance (BIA) was performed in 135 patients.) with the determination of the skeletal muscle mass index (SMMI).

This article presents the results of an analysis of the association of the results of tests assessing muscle mass, strength and function with the functional status of patients.

212-214 551
Abstract

BACKGROUND. Due tothe global increase in life extension and, as a result, the increase in the absolute number of older people suffering from chronic heart failure (CHF), it's becoming relevant to find a specific approach to their management. A special role in elderly patients with CHF may be played by the initial extracardial state of health, which consists of a combination of disorders in cognitive function, nutrition, social component and functional reserves. A large number of diagnostic methods for senile asthenia syndrome have been proposed, each of them has its advantages and limitations. However, there is currently no gold standard for the diagnosis of senile asthenia syndrome in patients with CHF. The Heart Failure Association of the European Society of Cardiology (HFA-ESC) proposed in 2019 a new definition of fragility with 4 domains―clinical, psycho-cognitive, functional, and social, however, their clinical and prognostic significance has not been fully determined.

215-217 539
Abstract

ACTUALITY. The use of physiotherapy methods is an effective and generally accessible means of improving the quality of life of patients with osteoporosis in the elderly and old age.

218-219 547
Abstract

RELEVANCE. Sarcopenia and knee osteoarthritis are the most common age-related diseases, which are an important part of the public health indicators of elderly patients around the world.

Osteoarthritis is a chronic joint disease that is closely related to aging. It is characterized by degeneration of cartilage, abnormal remodeling of subchondral bone and the formation of osteophytes at the edge of the joint, which cause severe pain and lead to disability.

Osteoarthritis is the most common joint disease worldwide, affecting about 10 % of men and 18 % of women aged 65–70.

Common cases of osteoarthritis increased by 113.25 % worldwide in 30 years, from 247.51 million in 1992 to 527.81 million in 2022.

Recent studies have identified various risk factors associated with knee osteoarthritis, including obesity, sedentary lifestyle, joint injuries, high-intensity sports activities and muscle loss.

Conclusions about the relationship between muscle mass and osteoarthritis of the knee joint are different.

Sarcopenia, progressive and generalized skeletal muscle disease,affecting from 10 % to 16 % of the elderly worldwide.

The Elderly Sarcopy Working Group (EWGSOP) updated the Sarcopy consensus, emphasizing low muscle strength as the main characteristic of geriatric syndrome.

220-222 514
Abstract

BACKGROUND. Cardiovascular diseases (hereinafter referred to as CVS) remain an important and pressing issue among public health and healthcare issues, as evidenced by the fact that about half of all causes of death among the adult population of the Russian Federation are associated with CVS diseases. One of the leading risk factors for their development is arterial hypertension and hypertension, especially in the context of risk factors in patients over 65 years of age. Due to the global trend of increasing life expectancy, this issue is becoming more relevant every year.

223-224 537
Abstract

ACTUALITY. Despite of established public perception that blood donation has a positive effect on the donors’ health and life expectancy, its long-term effects have been investigated insufficiently, and the available data are ambiguous. Most studies were retrospective, while prospective studies included mainly donors during their active donor career. The health of former donors who stopped donations for more than 10 years ago has not been studied specifically. To date, in the available literature, there are no data on the geroprotective effect of blood donation.

225-227 540
Abstract

RELEVANCE. Chronic heart failure (CHF) is an age-related disease affecting approximately 63 million people worldwide. In Russia, the prevalence of CHF has increased from 6.1 % to 8.2 % over the past 20 years, with most experts attributing this growth to population aging. Despite recent improvements in treatment strategies and, consequently, patient survival, mortality and hospitalization rates for CHF remain high, particularly among elderly and very elderly patients. Therefore, the search for new approaches to primary and secondary prevention and treatment of CHF remains a pressing issue in medical science.

Persistent systemic inflammation is a key component of the pathogenesis of age-related diseases, including CHF. Numerous studies have demonstrated elevated levels of inflammatory biomarkers in CHF patients. One of the mechanisms sustaining chronic inflammation is the accumulation of senescent cells, which secrete a complex of biologically active factors known as the senescence-associated secretory phenotype (SASP).

A promising approach to CHF treatment may be the use of senolytic therapy, which selectively eliminates senescent cells and reduces inflammation. The senolytic agent dihydroquercetin has demonstrated its effects in experimental studies, and its safety has been confirmed in clinical trials for other indications. These data justified the choice of dihydroquercetin for the present study, which aims to assess the effect of dihydroquercetin therapy on biomarkers of senescent cell accumulation and the clinical status of elderly patients with CHF.

228-230 516
Abstract

BACKGROUND. The risk of developing osteoarthritis increases with age: in the age group of 65–74 years old it is 49 %; in the group of 75–84 years old it is 61.1 %; and in the group over 85 years old it is 64.4 %. The rising prevalence of osteoarthritis leads to reduced mobility, loss of autonomy, increased disability, and a growing financial burden on the healthcare system. However, the number of publications addressing the association between geriatric syndromes and osteoarthritis remains limited. Individual studies often focus on the relationship between specific geriatric syndromes and osteoarthritis rather than assessing the overall geriatric status.

231-233 517
Abstract

BACKGROUND. Despite the achievements of modern medicine, stroke remains one of the leading causes of death and disability. Frailty is highly prevalent among patients with stroke history. According to the literature, frailty is identified in a quarter of patients, while pre-frailty is observed in about half of them. However, there is a lack of studies assessing the geriatric status of patients with a history of stroke.

234-235 511
Abstract

RELEVANCE. Cardiovascular diseases (CVD) remain the leading cause of death worldwide. Predicting the future occurrence of CVD remains a serious problem in medicine. In recent decades, progressive and exponential population aging has led to an increase in the prevalence of frailty syndrome (FS) and other geriatric syndromes (GS), one of which is orthostatic hypotension (OH). Frailty syndrome and OHsignificantly reduce the quality of life of older people. The relationships between them remain unclear. With vascular wall aging, arterial elasticity and carotid baroreceptor sensitivity to blood pressure (BP) changes decrease. Blood pressure regulation mechanisms are impaired, which leads to orthostatic reactions. Measurement of vascular wall stiffness (VWS) allows predicting future cardiovascular events, regardless of age or other CVD risk factors. However, data on arterial stiffness in the group of patients with FS are limited. 

236-238 524
Abstract

RELEVANCE. The STEMI-NSTEMI paradigm officially replaced the Q- and non-Q-wave myocardial infarction (MI) paradigm in 2000. This paradigm shift was driven by the reperfusion era, when several large randomized controlled trials demonstrated the efficacy of emergency reperfusion therapy, primarily with thrombolytic therapy. It was therefore necessary to identify patients who would benefit most from such treatment, and it turned out that these were patients with ST-segment elevation on the electrocardiogram (ECG), since such ECG changes in combination with clinical signs and/or symptoms of myocardial ischemia are highly suggestive of coronary artery (CA) occlusion.

However, coronary artery occlusion can be detected not only in patients with acute coronary syndrome (ACS) with ST segment elevation on the ECG, but also in patients with ACS without ST segment elevation on the ECG, as evidenced by the studies of Almendro-Delia M. (2020), Balbi M. M. (2021), Bruno F. (2023), Mohammad A. M. (2024). In this regard, it seems appropriate to analyze the data of patients with MI not only depending on the presence of ST segment elevation on the ECG but also depending on the presence of coronary artery occlusion. This is especially important in patients whose ECG interpretation is difficult: patients with rhythm and conduction disorders, with post-infarction cardiosclerosis, diabetes mellitus, elderly and senile age. It is noteworthy that there are no works devoted to the study of MI with occlusive coronary lesions in patients aged 75 years and older in the available literature.

239-240 527
Abstract

ACTUALITY. In clinical practice, magnesium deficiency in the body is detected in cardiovascular, bronchopulmonary, rheumatological diseases and neurodegenerative diseases. The determination of magnesium in serum is a routine method, however, the normal level of magnesium in the blood does not exclude the possibility of depletion of magnesium reserves in the body in persons over 65 years of age with signs of senile asthenia and sarcopenia. Early detection of magnesium deficiency at the cellular level can be determined in the erythrocyte mass, which will make it possible to identify magnesium depletion in the depot and determine the duration of replacement therapy with magnesium drugs.

241-242 537
Abstract

RELEVANCE.The state of the musculoskeletal system is an important factor in the quality of life and the preservation of autonomy of retired and elderly people. In recent years, the problem of coexistence the reduction in bone mineral density with the loss of muscle mass and function ― "osteosarcopenia" ― has become more and more urgent. Osteoporosis and sarcopenia, both in combination and separately, cause an increase in treatment costs and significantly affect the quality of life of the elderly.However, in the literature available to us, clinical information about the coexistence of pathology of the musculoskeletal system is insufficient, which determined the purpose of our investigation.

243-245 568
Abstract

RELEVANCE. With age, people experience a decline in cognitive and physical functions, which increases the risk of falls, loss of independence, and deterioration in quality of life. Mild cognitive impairment (MCI) is a common problem among older adults and often precedes the development of dementia. Modern research shows that cognitive training and combined rehabilitation programs, which integrate physical exercises and cognitive training, can have a positive impact on both cognitive abilities and physical activity, as well as quality of life. However, there is insufficient data on the extent of this impact in elderly patients, especially those with MCI.

246-247 602
Abstract

BACKGROUND. Physical activity is one of the key lifestyle factors influencing emotional well-being, cognitive function, and aging rate. Studying these associations in a healthy Russian population provides valuable insights for personalized interventions in longevity medicine.

248-250 537
Abstract

BACKGROUND. Chronic heart failure (CHF) is an age-associated disease: as the population ages, the prevalence of CHF doubles, increasing from 6 % in individuals aged 60–79 to 14 % in those aged 80 and older [1]. The prevalence of frailty among patients with CHF is higher than in the general population, with functional limitations reaching 56 %, cognitive impairments ― 37 %, and dependence on external assistance ― 66 % (according to the Barthel and Lawton scales) [2].

To date, the impact of personalized rehabilitation programs on the combined progression of these conditions remains poorly studied.

251-253 518
Abstract

BACKGROUND. The functional activity of elderly people with type 2 diabetes mellitus (T2DM) depends on multimorbidity and the severity of geriatric syndromes, therefore, the assessment of the effectiveness of geriatric rehabilitation (GR) is relevant. The POSTSCRIPTUM study was designed to study the effect of GR on the functional activity of patients aged 60 years and older, both regardless of comorbidities and taking into account the somatic status.

AIM. To assess the effect of the 1st stage of GR on the functional activity of patients over 60 years old with T2DM.

254-256 500
Abstract

BACKGROUND. The vast majority of elderly and senile patients are characterized by combined involvement of several organs and systems in the pathological process, which can manifest itself in a wide range of somatic disorders. According to statistics, more than 82.0 % of people over 65 years of age have chronic diseases that require constant drug therapy. Of these, up to 83.0 % of patients suffer from chronic diseases of the gastrointestinal tract. At the same time, continuous pharmacotherapy of existing non-gastroenterological pathology aggravates the prevalence and nature of damage to the digestive tract, including the stomach, small and large intestine in individuals with combined pathology. Although the data available today on the degree of damage to the gastrointestinal tract in comorbid individuals are still few, the presence of pain syndrome and various types of dyspepsia in patients of this group is a fairly common clinical situation that requires careful analysis when choosing therapeutic correction.

257-259 535
Abstract

The study highlights the importance of developing geriatric pharmacy and quality pharmaceutical counseling for elderly patients. The objective of the work is to optimize counseling for over-the-counter drug dispensing. A survey of pharmacists showed that elderly patients make up a significant portion of pharmacy visitors, and the prevalence of self-medication among them is high. Elderly people prefer inexpensive and domestic drugs, and cases of improper storage were found in their home medicine cabinets. Recommendations have been developed to improve the storage and disposal of drugs and medical devices, which will increase the safety and effectiveness of pharmaceutical care for this population group.

BACKGROUND. The relevance of the study is due to the global problem of population aging and the need to develop geriatric care, as stated in the „Strategy for Action in the Interests of Senior Citizens until 2025“. Geriatric pharmacy, including information and consulting services for elderly patients and their caregivers, is becoming an important part of this care. Elderly people often resort to self-medication, which requires high-quality pharmaceutical counseling. However, insufficient training of pharmacists in counseling geriatric patients can lead to unwanted side effects due to irrational use of drugs and their improper storage.

260-262 500
Abstract

We included 300 patients in the study. The neuropathic component of chronic pain syndrome was detected in one third of patients. Falls were detected in 73 patients (76.8 %) with clinical patterns of neuropathy, and in 99 patients (46.8 %) without them (p = 0.034). In the group of patients with neuropathic pain, a high risk of falls according to the fall risk self-assessment scale and 2 or more falls in the previous year were more common (p = 0.009 and p = 0.006, respectively) than in the comparison group. Thus, the presence of neuropathy in a patient with chronic pain syndrome is associated with a higher frequency and risk of falls.

BACKGROUND. Elderly patients are characterized by the persistence of chronic pain syndrome for decades, which leads to the appearance of neuropathic pain, which has a prevalence of 10 to 52 %. It is worth noting that there is insufficient data in the literature on the relationship of the neuropathic component of chronic pain syndrome with the frequency and risk of falls. While we assume that there is a relationship between them due to impaired nerve conduction, which leads to a decrease in all types of sensitivity.

263-264 513
Abstract

BACKGROUND. Currently, there is a global increase in the prevalence of nervous system disorders [1]. A significant proportion of these cases occur in elderly and senile patients [2]. Frailty syndrome is one of the key geriatric syndromes that, along with chronic diseases, can significantly impact the quality of life and prognosis in this patient population [3]. Investigating the relationship between frailty syndrome and nervous system disorders is now of great relevance.

265-267 534
Abstract

BACKGROUND. Polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) are diseases that develop in people over 50 years of age and often require long—term glucocorticoid (GC) therapy, which is associated with a high risk of side effects. In this regard, it is emergent to search for effective steroid-sparing drugs. Interleukin-6 (IL-6) inhibitors, such as tocilizumab and sarilumab, have already proven efficiency in the treatment of PMR and GCA. However, the availability of these drugs in Russia is limited, what makes the use of a domestic IL-6 inhibitor, olokizumab, promising.

268-270 513
Abstract

The results of studying the effect of EKOM Family Biotrons on the life span of BALB/C mice and Caenorhabditis elegans nematodes are presented. The concentrated biological action of Biotron was found to increase the average and maximum lifespan of these mice by 17.0 and 14.4 %, respectively, compared to the control. Biotron also maintains the motor activity of mice. The mobility of mice treated in the Biotron focus was on average 53.6 % higher compared to the activity of control mice located outside the Biotron. The average lifespan of nematodes increases by 8.6–30.1 %, and the maximum lifespan increases by 7.1–26.7 %.

 BACKGROUND. The importance of using Biotrons is that they allow increasing the lifespan of biological objects, and in the future, of people, when they are used already in adulthood or even old age, which distinguishes this method from other increasing life span means.

271-272 556
Abstract

The Radio Frequency Echographic Multi-Spectrometry (REMS) is a non-ionizing technology that can be used for diagnosing and monitoring osteoporosis, providing broader access to measuring bone mineral density (BMD) along the axial direction compared to standard dual-energy X-ray absorptiometry (DXA). REMS allows assessing BMD in specific patient groups with skeletal peculiarities such as metal implants, skeletal deformations, or conditions that make DXA difficult to perform. The portability and lack of ionizing radiation enable REMS to measure BMD at the bedside of immobile patients, avoiding complications associated with equipment installation (DXA) and related radiation protection measures.

273-275 516
Abstract

BACKGROUND. Currently, the number of patients with chronic heart failure (HF) is increasing worldwide [1]. Most of them are elderly patients [2]. The progression of HF affects the quality of life and can lead to dependence on outside help. Currently, it is relevant to assess the functional status in elderly patients with HF.

276-278 528
Abstract

Background. In the context of demographic aging, depopulation and workforce deficiency in Russia, the need for employment of aged workers will grow every year. Older workers are becoming an important part of the workforce of modern society, and their number will increase in the coming decades. The current problems of the workforce aging are characterized by an increase in the average age of the worker and the number of elderly workers, the presence of job categories where accelerated occupational aging is noted, as well as termination of work before retirement age, associated with the discrepancy between the occupation requirements and the functional capabilities of an aging organism. Specific changes that limit work ability, leading to a limitation of the range of body functional capabilities of the employees, a decrease in their reliability and an acceleration of the aging rates, require the introduction of a professional longevity management system based on the concept of occupational risks in employees’ accelerated aging. At the same time, age and work experience make a significant contribution to the valuable social capital of older workers: professional competence, intuitive knowledge, cooperation skills increase; the structural awareness of the organization and its functioning is expanding; the network of contacts with clients is expanding and the understanding of changes in the operational work environment is increasing.

279-281 83
Abstract

BACKGROUND. The number of patients with Chronic Heart Failure (CHF) worldwide is increasing. The prevalence of CHF increases with age: more than 10 % among people over 70 years of age, and up to 70 % in people over 90 years of age. As individuals age, the incidence of geriatric syndromes also increases. Despite this, large randomized clinical trials on CHF have low representation of older age groups and patients with frailty.

282-283 91
Abstract

BACKGROUND. In recent years, the number of patients with the diagnosis of «coxatrosis» has increased significantly. This diagnosis is often made only on the basis of complaints, X-ray data and MRI without proper clinical examination of patients. The ineffectiveness of conservative treatment leads to endoprosthesis of the hip joints.

284-285 130
Abstract

Currently, there is an increase in the number of patients over 80 years of age. Even with the continued activity of patients and the absence of severe somatic pathology or exacerbation of chronic, there is a tendency to frailty.

BACKGROUND. The number of patients over 80 years is currently increasing. Even with objectively maintained activity of patients and they do not have severe somatic pathology or exacerbation of chronic, there is a tendency to frailty.

286-288 95
Abstract

BACKGROUND. Pelvic organ prolapse (POP) remains a pressing medical issue that significantly affects women's quality of life. Although the role of obstetric and gynecological factors, such as multiple childbirths and age-related changes, has been established, the contribution of extragenital pathologies to the pathogenesis of POP remains insufficiently studied. Of particular importance is the increasing prevalence of comorbid conditions, including hypertension (HTN), diabetes mellitus (DM), and hypothyroidism, which may influence the development of structural disorders in connective tissue and pelvic floor muscles. A comprehensive analysis of the relationship between these diseases and POP is necessary to develop preventive measures and optimize treatment strategies.

289-291 68
Abstract

BACKGROUND. Due to the increase in life expectancy of the Russian population, clinicians increasingly often began to face urgent problems in the treatment of acute coronary syndrome (ACS) in patients over 90 years old. This is directly related to the exclusion of such patients from multicenter studies due to the high risk of complications and fatal outcomes, which "spoils" the statistical indicators of many specialized centers. The literature contains virtually no convincing data on the tactics and choice of the most optimal methods of treating ACS in this age group, which in turn is of great scientific interest in studying the risk factors for adverse outcomes in geriatric patients.

292-293 85
Abstract

BACKGROUND. In compressive-ischemic neuropathy of the ulnar nerve at the level of the cubital tunnel (cubital tunnel syndrome, CTS), surgical decompression is most effective. However, long-term surgical outcomes for CTS in elderly patients remain insufficiently studied.

294-297 73
Abstract

The conducted analysis of the results of examination and surgical treatment of elderly and senile patients suffering from post-infarction left ventricular aneurysm (PILVA) and chronic heart failure (CHF) of varying severity is of great scientific interest for further study and application in the practice of gerontology and geriatrics.

BACKGROUND. Chronic heart failure (CHF) is a key medico-social problem in Russia. Its prevalence among individuals over 65 years of age reaches 6–10 %. A significant component of CHF is post-infarction left ventricular aneurysm (PILVA), which occurs in 10 to 35 % of elderly and geriatric patients following myocardial infarction.

Post-infarction remodeling (PIR) processes during aneurysm formation temporarily compensate intracardiac hemodynamics, but only for a very short period. This occurs through the activation of short-term neurohumoral regulation mechanisms, followed by dysfunction of normokinetic myocardial mechanisms, leading to refractory CHF, early disability (within 6 months to 1 year), and high mortality (1 to 3 years) in elderly and geriatric patients receiving solely pharmacological therapy.

Thus, in this context, surgical treatments aimed at restoring normal geometric dimensions of the aneurysmal left ventricle (LV) combined with subsequent myocardial revascularization are the most optimal and play a decisive role in managing CHF in patients over 65 years of age. These patients were previously excluded from all studies addressing this issue.

The implementation of surgical treatments for CHF in patients with PILVA was preceded by a detailed study and evaluation of age-related pathophysiological features of compensatory cardiac mechanisms. This involved patient screening, inclusion/exclusion criteria, determining indications for the extent of surgery (selecting PILVA reconstruction techniques and myocardial revascularization methods), anesthetic management, postoperative care protocols, and assessments of quality of life before surgery, in the early (up to 30 days) and long-term (1 to 5 years) postoperative periods.



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