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Nutritional support in a comprehensive program of prevention and treatment of sarcopenia 营养支持在预防和治疗肌少症的综合方案
Pub Date : 2023-04-05 DOI: 10.37586/2686-8636-1-2023-29-38
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.
充足的营养和高蛋白含量是肌少症复杂治疗的主要条件之一。本文综述了维持肌少症患者膳食来源的蛋白质和氨基酸价值的策略。比较和概述了青年、中年和老年人包括肌肉减少症患者的营养饮食特点。营养补充蛋白质和氨基酸的可能性,在老年患者的饮食与肌肉减少症给出。
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引用次数: 0
Prevention of falls in the elderly and senile patients with cardiovascular diseases 预防老年人跌倒及老年心血管疾病患者
Pub Date : 2023-04-05 DOI: 10.37586/2686-8636-1-2023-14-28
O. Tkacheva, Y. Kotovskaya, K. Eruslanova, E. Alimova, N. Runikhina, A. Naumov, E. Frolova
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.
跌倒被定义为一种事件,导致一个人无意中在地面、地板或其他较低的地方休息,但由打击、失去意识、突然瘫痪或癫痫引起的情况除外。跌倒和害怕跌倒会造成严重的健康问题,而这些问题又与高受伤率、高医疗费用和对生活质量的负面影响有关。老年和老年心血管疾病(CVD)患者是跌倒的高危人群。然而,在临床实践中,跌倒的患病率和跌倒的风险并没有被医生和患者自己很好地理解和低估。跌倒风险的增加与多种因素有关,如药物、结构性心脏病、体位性低血压和心律失常,以及步态和平衡障碍、身体虚弱、感觉障碍。随着患有心血管疾病的老年人数量的增加,这些风险尤为重要。所有参与心血管疾病患者护理的医生都应重视成人心脏病患者跌倒的评估、预防和治疗,以及有跌倒风险的心血管疾病患者的治疗。
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引用次数: 0
Geriatric cardiology - an imperative of our time 老年心脏病学——我们这个时代的当务之急
Pub Date : 2023-04-05 DOI: 10.37586/2686-8636-1-2023-6-13
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.
心血管疾病是发病率和死亡率的主要原因,特别是在老年人中。老年人的特点是心血管疾病与其他非感染性慢性疾病的结合,认知和功能状况的变化,社会和经济环境的变化。迄今为止,还没有正式的指导方针来管理患者应对所有问题,因为历史上的临床建议是“以疾病为中心”,而老年心血管疾病患者需要一个包容和综合的以患者为中心的方法来确保全面的医疗保健。整合心血管疾病管理的基本原则和老年病学的原则对于为老年患者提供高质量的护理越来越有必要。
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引用次数: 1
Comprehensive geriatric assessment — the main tool for the work of a geriatrician 综合老年评估-老年专家工作的主要工具
Pub Date : 2023-02-01 DOI: 10.37586/2686-8636-4-2022-210-227
N. Sharashkina, O. Tkacheva, N. Runikhina, M. S. Arefieva, K. Eruslanova, V. S. Ostapenko, Y. Kotovskaya
A comprehensive geriatric assessment is the main diagnostic tool in the work of a geriatrician, which is also necessary for drawing up an individual plan for managing an older patient. A distinctive feature of the geriatric approach is a holistic perception of all the needs of an older person — not only medical, but also functional, social. The main goals of the CGA (comprehensive geriatric assessment) are to improve diagnostics, optimize treatment, and enhance the functional state and quality of life, including living conditions, the use of health-care services, and planning long-term support for older adults. Based on the results of the CGA, a comprehensive approach is being developed to provide assistance to older patients, which should help restore their independence, the ability to self-care, improve the quality of life through various targeted rehabilitation measures, as well as optimize healthcare costs, reduce risks, improve prognosis and increase life expectancy of the older patients.
全面的老年评估是老年医生工作中的主要诊断工具,这对于制定管理老年患者的个人计划也是必要的。老年病学方法的一个显著特点是全面了解老年人的所有需求——不仅是医疗需求,而且是功能需求和社会需求。老年综合评估(CGA)的主要目标是改进诊断、优化治疗、提高功能状态和生活质量,包括生活条件、保健服务的使用和为老年人规划长期支持。根据综合评估的结果,正在制定一项全面的办法,向老年患者提供援助,帮助他们恢复独立、自我照顾的能力,通过各种有针对性的康复措施改善生活质量,以及优化医疗保健费用、减少风险、改善预后和延长老年患者的预期寿命。
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引用次数: 2
Sarcopenic obesity — a current problem of modern geriatrics 肌少性肥胖——现代老年病学的一个当前问题
Pub Date : 2023-02-01 DOI: 10.37586/2686-8636-4-2022-228-235
D. P. Kurmaev, S. Bulgakova, E. Treneva
Sarcopenic obesity (SO) is a complex metabolic state of the body, attributable to a synergistic combination, mutual reinforcement and aggravation of the pathological mechanisms of sarcopenia and obesity. SO is associated with a decrease in the quality of life, dependence on outside help, an increased risk of disability and premature death. Currently, the urgency of the SO problem is increasing due to the global demographic aging of the population, the high incidence of obesity, type 2 diabetes mellitus (DM2), geriatric syndromes of sarcopenia and frailty in the developed countries of the modern world. It is of interest to review current literature data on the prevalence, etiology, pathogenesis, as well as the principles of diagnosis, prevention and treatment of sarcopenic obesity.
肌少性肥胖(Sarcopenic obesity, SO)是机体一种复杂的代谢状态,可归因于肌少症与肥胖的病理机制协同结合、相互强化、加重。SO与生活质量下降、依赖外界帮助、残疾风险增加和过早死亡有关。目前,由于全球人口老龄化,现代发达国家肥胖、2型糖尿病(DM2)、肌肉减少症和虚弱等老年综合征的高发,SO问题的紧迫性日益增加。本文对肌少性肥胖的患病率、病因、发病机制、诊断、预防和治疗原则等方面的文献资料进行综述。
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引用次数: 3
Oral health, frailty and physical activity levels: is there a link? 口腔健康、虚弱和身体活动水平:有联系吗?
Pub Date : 2023-02-01 DOI: 10.37586/2686-8636-4-2022-250-259
A. Turusheva, E. Frolova, O. Tkacheva, V. Trezubov, R. Rozov, M. Kabanov
Introduction. Oral frailty is associated with decreased quality of life and general health in older adults.Objective: to assess the relationship between oral frailty, physical frailty and physical functioning decline.Methods: An epidemiological cross-sectional Eucalyptus study of adults aged 65 years and older (n=396). The main study parameters: oral health status, chronic diseases, a comprehensive geriatric assessment, complete blood count.Results: 75.5% (n=299) of participants had less than half teeth. 87% of them used removable/fixed dentures or implants. Despite the high frequency of denture use, 9.4% (n=37) of study participants reported difficulties in pronunciation of words and 19.2% (n=76) complained of pain/discomfort when chewing food due to oral health/teeth/dentures. After adjusting for sex, age, cognitive decline, number of remaining teeth, denture/implant use, nutritional status and stroke/TIA, heart failure, chewing or speech problems due to problems of the oral cavity associated with teeth / oral mucosa / dentures were associated with low grip strength with OR (95% CI) 2.738 (1.306–5.737) and 2.494 (1.045– 5.952) respectively and frailty with OR (95% CI) 2.513 (1.083–5.829) in the group of study participants with difficulty in pronunciation of words. The association between chewing difficulty and frailty was significant after adjusting for sex, age, cognitive decline, number of remaining teeth, denture/implant use, nutritional status, and stroke/TIA with OR (95% CI) 2.002 (1.020–3.931), but disappeared after adjusting for heart failure.Conclusion: Chewing or pronunciation difficulties due to oral health problems were associated with an increased risk of frailty, and low levels of physical functioning. All patients with frailty and low physical function should be consulted by a prosthodontist.
介绍。口腔虚弱与老年人生活质量下降和总体健康状况有关。目的:探讨口腔虚弱、身体虚弱与身体功能下降的关系。方法:对65岁及以上的成年人(n=396)进行流行病学横断面桉树研究。主要研究参数:口腔健康状况、慢性疾病、老年综合评估、全血细胞计数。结果:75.5% (n=299)的参与者牙齿少于半颗。87%的患者使用活动/固定义齿或种植体。尽管使用假牙的频率很高,但9.4% (n=37)的研究参与者报告单词发音困难,19.2% (n=76)的研究参与者抱怨由于口腔健康/牙齿/假牙而咀嚼食物时疼痛/不适。在调整性别、年龄、认知能力下降、剩余牙齿数量、假牙/种植体使用、营养状况和中风/TIA、心力衰竭、咀嚼或言语问题(由于牙齿/口腔黏膜/假牙相关的口腔问题)分别与握力低(or)相关(95% CI) 2.738(1.306-5.737)和2.494(1.045 - 5.952),在单词发音困难的研究参与者组中,与or (95% CI) 2.513(1.083-5.829)相关。在调整性别、年龄、认知能力下降、剩余牙齿数量、假牙/种植体使用、营养状况和卒中/TIA (OR)后,咀嚼困难与虚弱之间的相关性显著(95% CI)为2.002(1.020-3.931),但在调整心力衰竭后,两者之间的相关性消失。结论:口腔健康问题导致的咀嚼或发音困难与身体虚弱和身体功能低下的风险增加有关。所有体弱多病和身体功能低下的患者都应咨询义齿医生。
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引用次数: 3
Vitamin K and age-related diseases 维生素K和老年性疾病
Pub Date : 2023-02-01 DOI: 10.37586/2686-8636-4-2022-236-249
K. Eruslanova, Y. Onuchina, E. Ivannikova, E. Dudinskaya
Vitamin K is a fat-soluble vitamin and its role in metabolism, bone and connective tissue, and blood coagulation is well known. The purpose of this review is to identify and detail the involvement of two vitamin K vitamers, K1 or phylloquinone, and vitamin K2 or menaquinone, in the pathogenesis of age-related diseases.
维生素K是一种脂溶性维生素,它在新陈代谢、骨骼和结缔组织以及血液凝固中的作用是众所周知的。本综述的目的是确定和详细说明两种维生素K维生素K1或叶绿醌和维生素K2或甲基萘醌在年龄相关疾病的发病机制中的作用。
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引用次数: 0
Social stigmatization and attitudes towards age-related changes 社会对年龄相关变化的污名化和态度
Pub Date : 2022-12-05 DOI: 10.37586/2686-8636-3-2022-156-160
I. A. Zakharova, A. Korobko, V. Sotnikov
Grounded in attitude to ethnicity, gender, health, age and other social variables social stigmatization is deeply entrenched in today's society. In the light of increasing life expectancy and changing in age structure of the population, the problem of gerontological ageism seems to be relevant. The negative view of the anthropometric, cognitive, physical characteristics of the older adults is acceptable to society thus adversely affecting their quality of life and secondarily reinforcing undesirable patterns. The paper outlines the basic ideas about this phenomenon, psychological and social determinants, research data, diagnostic methods, as well as possible ways to overcome the problem. An important task for gerontological specialists is educational work at all stages of interaction with older patients and their accompanying persons.
基于对种族、性别、健康、年龄和其他社会变量的态度,社会污名在当今社会根深蒂固。鉴于预期寿命的增加和人口年龄结构的变化,老年歧视问题似乎是相关的。社会可以接受对老年人的人体测量、认知和身体特征的消极看法,从而对他们的生活质量产生不利影响,并进而加强不受欢迎的模式。本文概述了这一现象的基本观点、心理和社会决定因素、研究数据、诊断方法以及克服这一问题的可能途径。老年学专家的一项重要任务是在与老年患者及其陪同人员互动的各个阶段进行教育工作。
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引用次数: 0
Radiology department of geriatric hospital: staff-patient interactions 老年医院放射科:医患互动
Pub Date : 2022-12-05 DOI: 10.37586/2686-8636-3-2022-150-155
E. A. Kruglov, D. A. Yatsenko, A. E. Zargarova, D. V. Demenok
Medical care organization for older patients in geriatric centers is of particular interest due to the increase proportion of older population in Russian Federation. Geriatric patients experience cognitive, neurological, sensory changes, including decreased vision, hearing, rate of reaction, as well as increased time for assimilation of new information. Patients with age-related characteristics may encounter various problems during examination in radiology departments. This article presents methodological recommendations for examination of older patients based on personal experience and analyzed literature.
由于俄罗斯联邦老年人口比例的增加,老年中心老年患者的医疗保健组织特别值得关注。老年患者会经历认知、神经和感觉方面的变化,包括视力、听力、反应速度下降,以及吸收新信息的时间增加。具有年龄相关特征的患者在放射科检查时可能会遇到各种问题。本文根据个人经验和文献分析,提出老年患者检查的方法学建议。
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引用次数: 0
The problem of preoperative assessment of patients of older age groups 高龄患者术前评估的问题
Pub Date : 2022-12-05 DOI: 10.37586/2686-8636-3-2022-161-167
D. V. Trotsyuk, Z. Zaripova, D. S. Medvedev, A. Volkov
Age-associated processes combined with comorbidity affect the physiological reserves of patients of older age groups, having a negative impact on the surgery and the postoperative period. One of the most important geriatric syndromes, closely related to the treatment outcome in patients over 60, is frailty. The prevalence of frailty increases with age, and that is associated with a worsening of the perioperative prognosis, prolonged hospitalization, and an increase in mortality. The methods widely used for perioperative risk stratification do not take into account the presence and severity of frailty, changes in the functional state and reserve capabilities of the body, which reduces their sensitivity for patients of older age groups. The article considers the generally accepted approaches to risk stratification and identifies further development prospects in this area.
年龄相关的过程和合并症会影响老年患者的生理储备,对手术和术后产生负面影响。与60岁以上患者的治疗结果密切相关的最重要的老年综合征之一是虚弱。虚弱的患病率随着年龄的增长而增加,这与围手术期预后的恶化、住院时间的延长和死亡率的增加有关。目前广泛应用的围手术期风险分层方法,没有考虑到虚弱的存在和严重程度、机体功能状态的变化和储备能力,降低了对老年患者的敏感性。本文考虑了普遍接受的风险分层方法,并确定了这一领域的进一步发展前景。
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引用次数: 0
期刊
Russian Journal of Geriatric Medicine
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