Pub Date : 2021-10-15DOI: 10.37586/2686-8636-3-2021-350-356
A. Naumov, D. V. Demenok, Y. Onuchina, N. O. Khovasova, V. I. Moroz, M. M. Balaeva
Osteoporosis and sarcopenia are age-associated diseases of the musculoskeletal system. Osteosarcopenia, the presence of osteopenia/osteoporosis and sarcopenia. The prevalence of osteosarcopenia in older adults with failing was 37% and associated with higher rate of death. Diagnosis of osteosarcopenia consists of describing medical history of fractures, providing x-ray of the spine (if it is needed) and bone densitometry, calculation of Fracture Risk Assessment Tool (FRAX), evaluating muscle strength, mass, function. The most common exam which is used to measure bone mineral density (BMD) is dual-energy x-ray absorptiometry (DXA or DEXA). Screening using the FRAX is recommended in all postmenopausal women and mеn over 50 in order to identify individuals with high probability of fractures. It is recommended to diagnose osteoporosis in patients with fragility fracture of large bones of the skeleton. Diagnosis of sarcopenia is consist of measures for three parameters: muscle strength, muscle quantity/quality and physical performance as an indicator of severity. Muscle strength can be measured with carpal dynamometry. Muscle mass can be evaluated dual-energy X-ray absorptiometry (program «Whole body»). Muscle function can be evaluated with short physical performance battery (SPPB) tests. In this article described algorithm of diagnosis of osteosarcopenia.
{"title":"Instrumental diagnosis of osteosarcopenia in diagrams and tables","authors":"A. Naumov, D. V. Demenok, Y. Onuchina, N. O. Khovasova, V. I. Moroz, M. M. Balaeva","doi":"10.37586/2686-8636-3-2021-350-356","DOIUrl":"https://doi.org/10.37586/2686-8636-3-2021-350-356","url":null,"abstract":"Osteoporosis and sarcopenia are age-associated diseases of the musculoskeletal system. Osteosarcopenia, the presence of osteopenia/osteoporosis and sarcopenia. The prevalence of osteosarcopenia in older adults with failing was 37% and associated with higher rate of death. Diagnosis of osteosarcopenia consists of describing medical history of fractures, providing x-ray of the spine (if it is needed) and bone densitometry, calculation of Fracture Risk Assessment Tool (FRAX), evaluating muscle strength, mass, function. The most common exam which is used to measure bone mineral density (BMD) is dual-energy x-ray absorptiometry (DXA or DEXA). Screening using the FRAX is recommended in all postmenopausal women and mеn over 50 in order to identify individuals with high probability of fractures. It is recommended to diagnose osteoporosis in patients with fragility fracture of large bones of the skeleton. Diagnosis of sarcopenia is consist of measures for three parameters: muscle strength, muscle quantity/quality and physical performance as an indicator of severity. Muscle strength can be measured with carpal dynamometry. Muscle mass can be evaluated dual-energy X-ray absorptiometry (program «Whole body»). Muscle function can be evaluated with short physical performance battery (SPPB) tests. In this article described algorithm of diagnosis of osteosarcopenia.","PeriodicalId":256357,"journal":{"name":"Russian Journal of Geriatric Medicine","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132342280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-10-14DOI: 10.37586/2686-8636-3-2021-313-318
T. M. Manevich, E. Mkhitaryan, A. Naumov
The high incidence of back pain in older people, its effect on quality and duration of life, and insufficient effectiveness of existing treatment methods determine the need to search for methods of back pain treatment that will reduce inflammatory and degenerative changes and the pain syndrome itself. The review analyzes the epidemiology, pathogenesis, current methods of pharmacotherapy for back pain, the role of genetic changes and biomarkers of chronic pain, discusses current prospects for the use of targeted therapy for the treatment of chronic nonspecific back pain based on pathogenetic mechanisms (genetic changes, aseptic inflammation, immune disorders, disorders of chondrogenesis, etc.).
{"title":"Perspectives of targeted therapy for nonspecific back pain: a review of recent publications","authors":"T. M. Manevich, E. Mkhitaryan, A. Naumov","doi":"10.37586/2686-8636-3-2021-313-318","DOIUrl":"https://doi.org/10.37586/2686-8636-3-2021-313-318","url":null,"abstract":"The high incidence of back pain in older people, its effect on quality and duration of life, and insufficient effectiveness of existing treatment methods determine the need to search for methods of back pain treatment that will reduce inflammatory and degenerative changes and the pain syndrome itself. The review analyzes the epidemiology, pathogenesis, current methods of pharmacotherapy for back pain, the role of genetic changes and biomarkers of chronic pain, discusses current prospects for the use of targeted therapy for the treatment of chronic nonspecific back pain based on pathogenetic mechanisms (genetic changes, aseptic inflammation, immune disorders, disorders of chondrogenesis, etc.).","PeriodicalId":256357,"journal":{"name":"Russian Journal of Geriatric Medicine","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126577739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-01DOI: 10.37586/2686-8636-2-2021-201-208
K. Belova, E. Bublik, E. Gladkova, H. G. Gordjeladze, E. Dudinskaya, D. Ladygina, M. S. Morozova, Y. Polyakova, L. Sivordova, V. Tanaev, O. Lesnyak
Background. To reduce the number of osteoporotic fractures in the world in recent years, — Fracture Liaison Service has been created. Since 2019, the development of a register of patients included in the Secondary Fracture Prevention named «Prometheus» has begun in Russia.Materials and methods. An information system for storing, searching and processing information has been created, and a registration card has been developed. Six FLS participate in the register management. As of 10.03.2021, data on 387 patients were introduced in the register.Results. Among the included patients, 46.25% received a fracture of the proximal femur, 20.41% — of the vertebral bodies and 16.80% of the proximal humerus, the rest had fractures of other localizations. The risk of fractures was assessed in all patients. A high risk of major osteoporotic fractures according to FRAX was determined in 160 (43.24%) people. Two-energy X-ray absorptiometry (DXA) was performed in 152 (39.28%) patients, and osteoporosis was detected in 103 (67.76%), osteopenia — in 42 (27.63%) patients. The risk of falls was assessed in 100% of the included patients, and the risk of falls was determined to be high in 343 (88.63%) patients. Evaluation of various laboratory parameters to find the causes of secondary osteoporosis was performed in most patients. After consultation with the FLS doctor, anti-osteoporotic drugs were prescribed to 241 (64.27%) people. Among the rest, 70 (52.24%) patients had contra-indications and 31 (23.13%) people needed further examination.Conclusions. Thus, the use of the register allows you to evaluate all the main sections of the organization of assistance within the FLS and compare them with international standards to identify «gaps» and improve the work of the service.
{"title":"First results of the register of patients with osteoporosis included in the secondary fracture prevention services","authors":"K. Belova, E. Bublik, E. Gladkova, H. G. Gordjeladze, E. Dudinskaya, D. Ladygina, M. S. Morozova, Y. Polyakova, L. Sivordova, V. Tanaev, O. Lesnyak","doi":"10.37586/2686-8636-2-2021-201-208","DOIUrl":"https://doi.org/10.37586/2686-8636-2-2021-201-208","url":null,"abstract":"Background. To reduce the number of osteoporotic fractures in the world in recent years, — Fracture Liaison Service has been created. Since 2019, the development of a register of patients included in the Secondary Fracture Prevention named «Prometheus» has begun in Russia.Materials and methods. An information system for storing, searching and processing information has been created, and a registration card has been developed. Six FLS participate in the register management. As of 10.03.2021, data on 387 patients were introduced in the register.Results. Among the included patients, 46.25% received a fracture of the proximal femur, 20.41% — of the vertebral bodies and 16.80% of the proximal humerus, the rest had fractures of other localizations. The risk of fractures was assessed in all patients. A high risk of major osteoporotic fractures according to FRAX was determined in 160 (43.24%) people. Two-energy X-ray absorptiometry (DXA) was performed in 152 (39.28%) patients, and osteoporosis was detected in 103 (67.76%), osteopenia — in 42 (27.63%) patients. The risk of falls was assessed in 100% of the included patients, and the risk of falls was determined to be high in 343 (88.63%) patients. Evaluation of various laboratory parameters to find the causes of secondary osteoporosis was performed in most patients. After consultation with the FLS doctor, anti-osteoporotic drugs were prescribed to 241 (64.27%) people. Among the rest, 70 (52.24%) patients had contra-indications and 31 (23.13%) people needed further examination.Conclusions. Thus, the use of the register allows you to evaluate all the main sections of the organization of assistance within the FLS and compare them with international standards to identify «gaps» and improve the work of the service.","PeriodicalId":256357,"journal":{"name":"Russian Journal of Geriatric Medicine","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124761279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-01DOI: 10.37586/2686-8636-2-2021-231-236
A. Naumov
The comorbidity of osteoarthritis and cardiovascular disease is the most frequent and typical polymorbidity in older patients. The identity of risk factors, low intensity pathogenetic effect of systemic inflammation, dyslipidemia define a greater degree and progression of both osteoarthritis and cardiovascular diseases in patients with a combination thereof. There is a significant decline in physical functioning and loss of autonomy. There is a higher risk of cardiovascular mortality in osteoarthritis patients. Only comprehensive programs involving physical rehabilitation, nutraceutical support, and pharmaceutical substances of chondroitin sulfate and glucosamine sulfate can supply effective and safe treatment in patients with osteoarthritis and cardiovascular disease.
{"title":"Cardiovascular comorbidity of osteoarthritis: clinical significance and therapy strategies","authors":"A. Naumov","doi":"10.37586/2686-8636-2-2021-231-236","DOIUrl":"https://doi.org/10.37586/2686-8636-2-2021-231-236","url":null,"abstract":"The comorbidity of osteoarthritis and cardiovascular disease is the most frequent and typical polymorbidity in older patients. The identity of risk factors, low intensity pathogenetic effect of systemic inflammation, dyslipidemia define a greater degree and progression of both osteoarthritis and cardiovascular diseases in patients with a combination thereof. There is a significant decline in physical functioning and loss of autonomy. There is a higher risk of cardiovascular mortality in osteoarthritis patients. Only comprehensive programs involving physical rehabilitation, nutraceutical support, and pharmaceutical substances of chondroitin sulfate and glucosamine sulfate can supply effective and safe treatment in patients with osteoarthritis and cardiovascular disease.","PeriodicalId":256357,"journal":{"name":"Russian Journal of Geriatric Medicine","volume":"70 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126200891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-01DOI: 10.37586/2686-8636-2-2021-176-185
M. Belov, K. Belova
Fractures of the proximal femur are a severe, life-threatening injury with enormous social, medical and economic consequences. Even with a well-organized system of medical care, up to 12-17% of patients die within the first year after injury, and the long-term risk of death doubles. Specially designed population-based studies in the Russian Federation have shown a high incidence of hip fractures in patients at the age of 50 and older. However, there is currently no unified system of medical care organization for all regions of Russia, which allows hospitalization and operation of patients with hip fractures during the first hours after trauma. Hip fracture in an elderly person is an absolute indication for the hospitalization. However most patients have severe comorbidities, osteoporosis, an increased risk of falls and mortality because of any reason. The main surgical treatments for hip fractures include osteosynthesis of the fracture or hip arthroplasty. It is well known that after the occurrence of any fragility fracture the risk of subsequent fractures increases by 2-3 times. To ensure the continuity of patient management, provide prescription of anti-osteoporotic drugs and long-term follow-up of patients it is necessary to manage them within the special Fracture Liaison Services (FLS). The article is devoted to the organization of medical care in patients of older age groups who have received hip fractures. A review of modern approaches to the treatment and organization of care for elderly patients with hip fractures is based on the methodological recommendations «Complex measures aimed at preventing falls and fractures in the elderly» developed in the framework of the federal project «The Older Generation», the draft national clinical guidelines «Fractures of the proximal femur», as well as the results of our own research.
{"title":"Contemporary view of medical care of the elderly people with proximal femur fractures","authors":"M. Belov, K. Belova","doi":"10.37586/2686-8636-2-2021-176-185","DOIUrl":"https://doi.org/10.37586/2686-8636-2-2021-176-185","url":null,"abstract":"Fractures of the proximal femur are a severe, life-threatening injury with enormous social, medical and economic consequences. Even with a well-organized system of medical care, up to 12-17% of patients die within the first year after injury, and the long-term risk of death doubles. Specially designed population-based studies in the Russian Federation have shown a high incidence of hip fractures in patients at the age of 50 and older. However, there is currently no unified system of medical care organization for all regions of Russia, which allows hospitalization and operation of patients with hip fractures during the first hours after trauma. Hip fracture in an elderly person is an absolute indication for the hospitalization. However most patients have severe comorbidities, osteoporosis, an increased risk of falls and mortality because of any reason. The main surgical treatments for hip fractures include osteosynthesis of the fracture or hip arthroplasty. It is well known that after the occurrence of any fragility fracture the risk of subsequent fractures increases by 2-3 times. To ensure the continuity of patient management, provide prescription of anti-osteoporotic drugs and long-term follow-up of patients it is necessary to manage them within the special Fracture Liaison Services (FLS). The article is devoted to the organization of medical care in patients of older age groups who have received hip fractures. A review of modern approaches to the treatment and organization of care for elderly patients with hip fractures is based on the methodological recommendations «Complex measures aimed at preventing falls and fractures in the elderly» developed in the framework of the federal project «The Older Generation», the draft national clinical guidelines «Fractures of the proximal femur», as well as the results of our own research.","PeriodicalId":256357,"journal":{"name":"Russian Journal of Geriatric Medicine","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125294705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-01DOI: 10.37586/2686-8636-2-2021-250
V. Moroz, N. O. Khovasova, A. Naumov
Цель: установление влияния мышечной массы и силы на интенсивность и длительность болевого синдрома у пациентов старше 60 лет.
目标:在60岁以上的患者中，肌肉质量和力量对疼痛综合征的强度和持续时间的影响。
{"title":"The effect of muscle mass and strength on the intensity and duration of pain syndrome in patients over 60 years of age","authors":"V. Moroz, N. O. Khovasova, A. Naumov","doi":"10.37586/2686-8636-2-2021-250","DOIUrl":"https://doi.org/10.37586/2686-8636-2-2021-250","url":null,"abstract":"Цель: установление влияния мышечной массы и силы на интенсивность и длительность болевого синдрома у пациентов старше 60 лет.","PeriodicalId":256357,"journal":{"name":"Russian Journal of Geriatric Medicine","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128779408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-01DOI: 10.37586/2686-8636-2-2021-249
A. Balashova, I. Glinkina, V. Fadeev
Цель: оценить распространенность когнитивных нарушений (КН) у пожилых пациентов с сахарным диабетом (СД) 2 типа.
目标:评估糖尿病患者(cn)认知障碍的普遍程度(cn) 2型糖尿病患者。
{"title":"The Epidemiology of Cognitive impairment in elderly patients with type 2 diabetes mellitus: prevalence and related clinical factors","authors":"A. Balashova, I. Glinkina, V. Fadeev","doi":"10.37586/2686-8636-2-2021-249","DOIUrl":"https://doi.org/10.37586/2686-8636-2-2021-249","url":null,"abstract":"Цель: оценить распространенность когнитивных нарушений (КН) у пожилых пациентов с сахарным диабетом (СД) 2 типа.","PeriodicalId":256357,"journal":{"name":"Russian Journal of Geriatric Medicine","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127632793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-01DOI: 10.37586/2686-8636-2-2021-255
M. Fedorova, I. Novikova
Цель: определить степень информированности лиц пожилого и старческого возраста об оказании гериатрической помощи в Архангельской области.
目标:确定老年人和老年人对在大天使地区提供老年援助的认识程度。
{"title":"Elderly and seniors awareness about geriatric care in the Arkhangelsk region","authors":"M. Fedorova, I. Novikova","doi":"10.37586/2686-8636-2-2021-255","DOIUrl":"https://doi.org/10.37586/2686-8636-2-2021-255","url":null,"abstract":"Цель: определить степень информированности лиц пожилого и старческого возраста об оказании гериатрической помощи в Архангельской области.","PeriodicalId":256357,"journal":{"name":"Russian Journal of Geriatric Medicine","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130720862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-01DOI: 10.37586/2686-8636-2-2021-254
V. Logina, P. Glazkova, D. Kulikov, A. A. Glazkov, K. A. Kozlova, D. Rogatkin
Цель: оценить корреляцию реактивности микроциркуляторного звена кровообращения с биологическим и хронологическим возрастом.
目标:评估微循环回路与生物和时间年龄之间的反应性相关。
{"title":"The connection between changes in the cutaneous microcirculation reactivity and biological age in patients with diabetes mellitus. Pilot study","authors":"V. Logina, P. Glazkova, D. Kulikov, A. A. Glazkov, K. A. Kozlova, D. Rogatkin","doi":"10.37586/2686-8636-2-2021-254","DOIUrl":"https://doi.org/10.37586/2686-8636-2-2021-254","url":null,"abstract":"Цель: оценить корреляцию реактивности микроциркуляторного звена кровообращения с биологическим и хронологическим возрастом.","PeriodicalId":256357,"journal":{"name":"Russian Journal of Geriatric Medicine","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125705031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-08-01DOI: 10.37586/2686-8636-2-2021-209-219
N. Vorobyeva, N. O. Khovasova, O. Tkacheva, Y. Kotovskaya, E. V. Selezneva, L. Ovcharova
Background. In the Russian Federation, the prevalence of falls and fractures in older people in the general population is unknown. Single studies have been carried out on small samples (hospitalized patients, patients with diabetes mellitus etc.). Objective. To investigate history of low-energy fractures, frequency of falls in the past year and their associations with other geriatric syndromes (GS) in subjects aged ≥65 years.Materials and methods. We examined 4308 subjects (30% of men) aged 65 to 107 years (mean age 78 ± 8 years) in 11 regions of the Russian Federation, who were divided into 3 age groups (65-74, 75-84 and ≥85 years old). All participants underwent comprehensive geriatric assessment, which consisted of two stages: 1) survey on a specially designed questionnaire; 2) physical examination.Results. The frequency of falls over the past year was 30%, including 25,7% — in subjects aged 65-74 yrs, 29,8% — 75-84 yrs, 37,3% — ≥85 yrs (p for trend <0,001). Of these, 62% of participants fell 1 time, 38% — 2 times or more. With the same frequency, the subjects fell at home (41%) and on the street (42%), 17% of subjects fell both at home and on the street. A history of low-energy fractures was found in 17% of the participants, among which the most frequent (63%) were fractures of the radius. Univariate regression analysis with sex and age (as a discret variable) adjustment, where the falls in the past year were considered as the dependent variable, and GS as independent one, demonstrated that all GS were associated with falls in the past year with odds ratios (ORs) ranging from 1,25 to 3,13. Multivariate regression analysis with age and sex adjustment showed that independent predictors of falls were female gender (ORs 1,51; 95% confidence interval 1,26-1,82; р<0,001) and 6 GS (malnutrition, depression, urinary and fecal incontinence, chronic pain and dependence in instrumental activities in daily life) with a 1,3-2,4 times increase of falls risk.Conclusion. In EVKALIPT study we firstly obtained the domestic data on the prevalence of falls and low-energy fractures history in subjects aged >65 years in the general population and studied associations between falls in the past year and other geriatric syndromes.
{"title":"Falls and fractures in subjects over 65 years old and their associations with geriatric syndromes: Russian epidemiological study EVKALIPT","authors":"N. Vorobyeva, N. O. Khovasova, O. Tkacheva, Y. Kotovskaya, E. V. Selezneva, L. Ovcharova","doi":"10.37586/2686-8636-2-2021-209-219","DOIUrl":"https://doi.org/10.37586/2686-8636-2-2021-209-219","url":null,"abstract":"Background. In the Russian Federation, the prevalence of falls and fractures in older people in the general population is unknown. Single studies have been carried out on small samples (hospitalized patients, patients with diabetes mellitus etc.). Objective. To investigate history of low-energy fractures, frequency of falls in the past year and their associations with other geriatric syndromes (GS) in subjects aged ≥65 years.Materials and methods. We examined 4308 subjects (30% of men) aged 65 to 107 years (mean age 78 ± 8 years) in 11 regions of the Russian Federation, who were divided into 3 age groups (65-74, 75-84 and ≥85 years old). All participants underwent comprehensive geriatric assessment, which consisted of two stages: 1) survey on a specially designed questionnaire; 2) physical examination.Results. The frequency of falls over the past year was 30%, including 25,7% — in subjects aged 65-74 yrs, 29,8% — 75-84 yrs, 37,3% — ≥85 yrs (p for trend <0,001). Of these, 62% of participants fell 1 time, 38% — 2 times or more. With the same frequency, the subjects fell at home (41%) and on the street (42%), 17% of subjects fell both at home and on the street. A history of low-energy fractures was found in 17% of the participants, among which the most frequent (63%) were fractures of the radius. Univariate regression analysis with sex and age (as a discret variable) adjustment, where the falls in the past year were considered as the dependent variable, and GS as independent one, demonstrated that all GS were associated with falls in the past year with odds ratios (ORs) ranging from 1,25 to 3,13. Multivariate regression analysis with age and sex adjustment showed that independent predictors of falls were female gender (ORs 1,51; 95% confidence interval 1,26-1,82; р<0,001) and 6 GS (malnutrition, depression, urinary and fecal incontinence, chronic pain and dependence in instrumental activities in daily life) with a 1,3-2,4 times increase of falls risk.Conclusion. In EVKALIPT study we firstly obtained the domestic data on the prevalence of falls and low-energy fractures history in subjects aged >65 years in the general population and studied associations between falls in the past year and other geriatric syndromes.","PeriodicalId":256357,"journal":{"name":"Russian Journal of Geriatric Medicine","volume":"272 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115964595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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