An increasing senior population requires improvements in geriatric care. Elderly patients are prone to various age-related diseases combined with geriatric symptoms. In such cases, medical treatment involves collaboration between doctors of different specializations, nurses, social workers, and care professionals. To make such collaboration as efficient as possible, appropriate professional training and a regulatory framework for interaction, along with well-defined medical care algorithms, are necessary.

The slowing phenotype, which is widespread among geriatric patients, is a variant of unhealthy aging that conceptually links the physical, cognitive, and emotional status of the patient. The development of simple and accessible diagnostic algorithms and further study of this phenotype are of paramount importance for understanding the mechanisms of its progression and developing the most effective therapeutic strategies for correction.

OBJECTIVE: to study the prevalence of cognitive dysfunction (CD), depression, and the slowing phenotype among patients with sarcopenia and sarcopenic obesity (SO) and to assess the clinical and functional relationships between these clinical manifestations and dyspnea in the study cohort.

MATERIALS AND METHODS. In a cross-sectional observational study of 227 geriatric patients divided into four comparative groups (with sarcopenia, with SO, with obesity without sarcopenia, control group without sarcopenia and obesity), the frequency of CD, depression, dyspnea, and the slowing phenotype was studied. The McNaught and Kane scale was used to identify cognitive impairment. Depression was assessed using the Geriatric Depression Scale (GDS-15). The Modified Medical Research Council (mMRC) and Borg scales were used to interpret the severity of dyspnea.

RESULTS. The mean age of the study participants was (76.48 ± 6.94) years, with a predominance of female subjects (73.57 %). Among patients with sarcopenia and sarcopenic obesity, the greatest number of individuals with cognitive deficit, depression, and the slowing phenotype were identified. Patients with dyspnoea were found to be numerically and more severely predominant in the sarcopenic obesity and non-sarcopenic obesity groups. Statistically significant relationships were established between sarcopenia and cognitive dysfunction (c² = 27.34; p < 0.001; С = 0.38 — average relationship), and between sarcopenia and depression (c² = 10.82; p = 0.002; С = 0.24 — average relationship). The present study found a statistically significant correlation between dyspnoea and depression (r = 0.20; p = 0.049), fatigue (r = 0.33; p = 0.008) and average relationship with obesity (c² = 7.85;  p = 0.006; C = 0.27). Conversely, obesity was not associated with cognitive dysfunction or depression.

CONCLUSION.  Among patients with sarcopenia and sarcopenic obesity, there is a high frequency of cognitive dysfunction, depression, and the slowing phenotype, which represents the most unfavorable prognostic variant of aging. Indirectly, dyspnea in such patients can aggravate the condition due to the negative impact on fatigue, physical function, and depression.

Cognitive disorders are one of the most significant problems for elderly and senile people. Particular attention should be paid to the diagnosis of early pre-dementia stages of cognitive impairment: subjective and subtle cognitive decline and mild cognitive impairment. The review presents current concepts of classification of pre-demential forms of cognitive decline, their diagnosis, and therapeutic approaches to managing patients with these disorders. Non-pharmacological methods for managing patients with initial forms of cognitive declines are discussed. The importance of cognitive training, physical activity, and socialization for such patients is highlighted. When considering drug therapy for pre-demetial cognitive impairment, the safety profile of medications is discussed, especially in the elderly population, where it is important. Finding safe and well-tolerated medications for elderly patients remains a priority for specialists. The possibility of using Prospekta in the management of patients with early cognitive decline is being considered.

Osteoporosis is one of the most significant medical problems, especially in the context of global population aging. With increased life expectancy, the number of elderly patients with this pathology is growing, which has significant medical and socio-economic consequences. Osteoporosis is characterized by a decrease in bone mineral density, which significantly increases the risk of fractures, especially in older age groups. These pathological changes not only worsen the quality of life of patients, but also lead to increased healthcare costs and increase the social burden.

BACKGROUND. Osteoarthritis (OA) is a major medical and social problem in modern society, as it is the leading cause of impaired mobility, loss of independence, and disability. Sarcopenia, which often coexists with OA, minimizes the effectiveness of non-pharmacological treatment programs for osteoarthritis. There is considerable clinical interest in the efficacy of symptomatic slow-acting drugs (disease-modifying agents), focused on the clinical manifestations of sarcopenia.

OBJECTIVE. To evaluate changes in muscle strength and function during therapy with a bioactive concentrate derived from small marine fish in patients with chronic nonspecific musculoskeletal pain and probable sarcopenia.

MATERIALS AND METHODS. A single-center, open-label, prospective, phase IV comparative post-marketing study was designed to assess changes in muscle strength and function during treatment with a bioactive concentrate derived from small marine fish in 60 geriatric patients with probable sarcopenia and chronic nonspecific musculoskeletal pain.

RESULTS AND DISCUSSION. During therapy, an increase in muscle strength was observed in both the intervention and control groups. Handgrip strength increased by 44.3 % over 2 months in the intervention group (from  14.7 kg to 21.2 kg), compared with a 5.9 % increase in the control group. Over the observation period, «Timed Up and Go» decreased by 40.6 % in the intervention, with most patients reaching the reference value compared to a 22.9 % reduction in the control. Gait speed increased by 6.5 % in the first month versus 2.4 % in the second month in the intervention. Pain reduction reached 83.1 % in the group after 2 months, compared to 22.8 % in the control (p = 0.02).

CONCLUSION. The inclusion of a bioactive concentrate from small marine fish in the comprehensive management of pain exacerbations in patients with chronic nonspecific musculoskeletal pain and probable sarcopenia resulted in a greater reduction in pain compared to the control group. Under pain control conditions, indicators of muscle strength were significantly improved in the group receiving the bioactive concentrate compared to those in the control group.