The consensus statement provides expert opinion on key items in planning and designing clinical trials for medications that are intended for use mainly or probably in geriatric patients.

Syncope can lead to a fall and cause injury, hospitalization, loss of autonomy, and even death. In the older, syncope can be caused by cardiovascular system diseases, including orthostatic hypotension, carotid sinus syndrome, neuromediated syncope, structural heart disease, and abnormalities in cardiac rhythm and conduction. A structured and comprehensive approach to the management of older patients with falls triggered by syncope is required. Diagnosis and treatment of syncope have several difficulties in older patients with both preserved and impaired cognitive functions. When diagnosing these patients both the classical cardiological examination and the implementation of a comprehensive geriatric assessment are used. Comprehensive approach allows assessing in detail the cause of fainting and choosing the optimal diagnostic and treatment tactics in older patients.

Background. Hearing impairment, according to official statistics, occurs in 14% of Russians aged 45–64 and 35% of residents over the age of 75 [1, 8, 11]. According to the forecasts of the World Health Organization (WHO), by 2050, almost 2.5 billion people will suffer from hearing problems to some extent and at least 700 million people will need rehabilitation services due to hearing loss [3, 18].

Aim. To study the features of cochlear implantation and evaluate the effectiveness of hearing and speech rehabilitation in older people.

Materials and methods. We observed 25 patients with a diagnosis of grade IV postlingual chronic bilateral sensorineural hearing loss, borderline with deafness (18 women and 7 men), who underwent cochlear implantation at the National Medical Research Center of the Federal Medical and Biological Agency of Russia. Before surgical treatment, all patients underwent a comprehensive audiological examination: tonal threshold audiometry, acoustic impedance measurement, registration of otoacoustic emission, registration of short-latency auditory evoked potentials, free sound field audiometry in hearing aids, speech audiometry in a free sound field in hearing aids. In the postoperative period, tonal threshold audiometry with a speech processor was performed. The mean age of patients at the time of cochlear implantation was 68.6 years.

Results. We have analyzed the effectiveness of the speech processor adjustment of a cochlear implant in a group of older patients in dynamics by performing tonal threshold audiometry in a free sound field.

Conclusion. Cochlear implantation in older adults can improve patients’ life quality, which is a criterion for meeting international standards of medical care.

The review focuses on the issue of type 2 diabetes mellitus (T2D) in older patients and novel coronavirus infection (COVID-19). In accordance with the analyzed articles, comorbidity, pro-inflammatory state, diminished innate immune response, vascular dysfunction and tendency to thrombosis in people with T2D, contribute to a higher susceptibility to SARS-CoV-2 infection and a poor prognosis. The using of Subetta is possible in add-on therapy for older patients with transient hyperglycemia, insulin resistance and type 2 diabetes mellitus in order to achieve carbohydrate metabolic compensation and improve the quality of life.

This publication draws attention to the state of geriatric care and the way of its development in Moscow, the usage of geriatric practices with proven effectiveness, as well as solving the issues of organizing medical care according to the «geriatrics» profile for elderly and senile patients.

Background. The prevalence of chronic pain syndrome in general population of older adults in the Russian Federation is unknown.

Aim. To study the prevalence and features of chronic pain syndrome in subjects aged ≥65 years.

Materials and methods. There were examined 4308 subjects (30% males) aged from 65 to 107 years (mean age 78±8 years), living in 11 regions of the Russian Federation, who were divided into 3 age groups (65–74 years, 75– 84 years and ≥85 years). All participants underwent a comprehensive geriatric assessment consisted of two stages: 1) questioning based on a specially designed questionnaire; 2) physical examination. The «Chronic pain» module of questionnaire included: 1) questions concerning the presence, localization, character and frequency of chronic pain syndrome, as well as the frequency of taking analgesics; 2) self-assessment of pain intensity on a visual-analogue scale at the moment of examination and for the previous week; 3) DN4 questionnaire to detect neuropathic pain.

Results. The prevalence of chronic pain syndrome was 87.2%, including 83.8% in subjects aged 65–74 years, 87.7% — 75–84 years, 91.1% — ≥85 years (p for trend <0.001). In women, chronic pain was detected more often than in men (90.2% vs. 80.2%; p<0.001). The most frequent localization of pain syndrome were large joints (75%), back (68%) and head (64%). The prevalence of different types of pain was as follows: nociceptive — 67.3%, neuropathic — 21.2%, nociplastic — 11.4%. With age, the frequency of detection of neuropathic pain increased (from 18.9% in patients aged 65–74 to 23.8% in patients ≥85 years; p for trend = 0.013), nociplastic, on the contrary, decreased (from 13.8% to 9%; p for trend = 0.001), and nociceptive — remained unchanged (67.3% in patients aged 65–74, 67.6% — 75–84 years, 67.2% — ≥85 years; p for trend = 0.974). In patients with neuropathic pain, more severe manifestations of pain syndrome were revealed: they were more likely to experience pain of any localization with a large number of pain zones/areas, they had a higher frequency and intensity of pain syndrome, and they were more likely to take analgesics and noted limitations in daily life due to pain.

Conclusion. In the EVKALIPT study, for the first time, domestic data on the prevalence and features of chronic pain syndrome in subjects aged ≥65 years in the general population was obtained.

The review is to consider remote components of interdisciplinary medical and social support for the older adults, taking into account the prevention of the development and/or progression of major geriatric syndromes during COVID-19 infection. Since March 2020 till the present, the Chair of Medical Rehabilitation and Physical Education with the course of the Faculty of Advanced Training and Staff Retraining together with the Labor, Employment and Social Protection Committee of the Vitebsk Regional Executive Committee have carried out an interdisciplinary support «Current issues of quality of life in older people», during the period of COVID-19 infection. A method of medical and social interdisciplinary online support of seniors in conditions of COVID-19 infection has been introduced into practice, including online counseling and adaptive physical education, a mobile observation form, an educational component, a remote component of medical rehabilitation at outpatient and home stages, YouTube project «Let's help each other to recover after pneumonia».

Chronic pain syndrome is one of the most common geriatric syndromes. Chronic pain negatively affects the mobility and autonomy of the older person, reducing the quality of life and longevity. An active screening for chronic pain in the geriatric population improves the geriatric status. Treatment strategies for chronic pain in older patients include non-pharmacological measures as well as drug administration. However, advanced age is associated with high comorbidity, polypharmacy, and in some cases does not allow the active use of systemic non-steroidal anti-inflammatory drugs (NSAIDs). In this connection, the use of parenteral symptomatic slow-acting drugs, the representative of which is chondroitin sulfate (CS), becomes an alternative. The efficacy and safety of CS has been proven by the mean of clinical studies meta-analysis data of osteoarthritis treatment effectiveness with parenteral chondroitin sulfate, including patients with back pain.