Advances in gerontology = Uspekhi gerontologii / Rossiiskaia akademiia nauk, Gerontologicheskoe obshchestvo最新文献

Approaches to the classification and identification of boundaries of the elderly have been studied, the age structure of the population of the Republic of Belarus and the Grodno region has been calculated, using materials from a database representative of the Grodno region, and an analysis of the quality of life of persons aged 60+ has been carried out. It has been established that, in general, the state of medical and social predictors of self-perception of people 60 years of age and older in the Grodno region can be considered favorable, which is reflected in the maximum values of quality of life in the domains «Microsocial support» and «Social well-being» (95% CI 66,2±0,6%), and also that the integral level of quality of life corresponds to an increased level (64,26±0,52%). A demographically older population with expanded working capacity limits reduces the risk of stigmatization of the elderly. The domain «Physical and psychological well-being» revealed the lowest values (95% CI 61,52±0,55%). The domain has a direct connection with satisfaction with one's own health, with how a person in old age is able to compensate for accumulated disorders and what conditions he has for this. The measures taken in the Republic of Belarus in this direction in the healthcare system receive strong government support.

Chronic obstructive pulmonary diseases occupy a significant place in the structure of diseases in the elderly and senile and contribute to the diversity and multiplicity of combined pathology, impaired quality of life and causes of mortality in the elderly. One of the leading tasks in the treatment of vascular disorders, which are of particular importance in arterial hypertension combined with COPD in elderly patients, is to improve macrohemodynamics and microcirculation by improving endothelial function, normalizing the relationship between the endothelium and blood cells, reducing the level of markers of chronic inflammation and angiogenesis. The aim of the work: to study the effect of arterial hypertension on the state of angiogenesis inducers in elderly patients with COPD. It has been established that in the development of isolated COPD, the activity of both platelet-derived growth factor AA and tumor necrosis factor α directly depends on age, smoking index and spirometric parameters, in particular, on the forced expiratory volume in first second. The development of concomitant arterial hypertension in elderly patients with COPD promotes stimulation of angiogenesis and an increase in the severity of systemic inflammation.

The growing older adults' population made their well-being as a global concern. Considering the cultural and contextual differences across societies, it is essential to explore the dimensions of well-being within each specific context. This study aims to identify the dimensions of well-being from the perspective of Iranian older adults. This study employed a qualitative approach, conducting 21 in-depth interviews with older adults, selected through purposive sampling across different districts of Tehran. The interviews were analyzed based on directed content analysis. The findings were compared to a framework developed from a prior scoping review. Six dimensions of well-being identifies in the theoretical framework were confirmed through the interviews, though some subcategories differed. Key findings included: independence and autonomy in daily life and the burden of high healthcare expenditures under the Health dimension; warm family relationship and child's well-being in Social Relationships; inadequate income and financial hardship in Economic Status; recreational activities and trips in Environment and Leisure; and the role of education and literacy in Capabilities and Resources. Economic challenges were particularly impactful on the subjective well-being of older adults. Economic difficulties, peaceful family environment and children's well-being emerged as significant factors in the well-being of Iranian older adults compared to previous theoretical framework.

The study of biomarkers of age-related viability (resilience) in gerontology and geriatrics is actively continuing, but it has practically not been considered in patients with low-energy fractures. The aim of the study was to analyze the association of age-related viability with systemic inflammation in low-energy fractures. Among 102 patients after 2,5-3 months of low-energy fractures, stability in the motor and cognitive domains of walking speed, the 6-minute walking test and MMSE, respectively, were studied. A decrease in the motor domain was found in 78,43±3,61% of cases and the cognitive domain in 67,65±3,12% of cases (p<0,01). In patients with a decrease in the motor domain, the content of all pro-inflammatory cytokines is significantly higher compared to representatives with a decrease in the cognitive domain. This is especially true for the level of IL-6, which in patients with decreased motor domain was 30,4±1,5 pg/ml versus 12,1±0,8 pg/ml, TNF-α was 41,2±2,3 and 17,6±0,9 pg/ml, and IL-1b was 24,8±1,6 and 10,6±0,7 pg/ml, respectively. Multiple beta regression coefficients show a negative association with pro-inflammatory cytokines among both patients with low-energy fractures with a decrease in the motor domain and a decrease in the cognitive domain. However, the association with IL-10 is positive and the β coefficient was +1,95 for a decrease in the motor domain and +1,32 for a decrease in the cognitive domain.

Based on their own clinical experience and literature data, the authors present the features of collecting anamnesis of the disease and examining elderly and senile patients. Practical methods of interviewing an elderly patient with age-related memory disorders (collecting an anamnesis of the disease at the same time as the anamnesis of life), hearing (being in the patient's field of vision, avoiding high tones in the voice, speaking clearly, slowly, in silence, the doctor's face should be clearly visible to the patient) are proposed. The article presents the features of collecting medical history from a patient with age-related psychological personality traits (rigidity of thinking, increased suggestibility, perception of existing symptoms as natural manifestations of aging). The deontological aspects of the relationship between a doctor and an elderly patient are considered. The age-related features of the physical examination of an elderly patient were noted: gait, speech, voice, anthropometric data, skin (senile keratomas, senile hemangiomas, senile purpura Bateman), senile pulmonary emphysema, senile heart, tense pulse, high pulse pressure, senile aortic stenosis, etc.). The features of interpretation of data from laboratory and instrumental research methods in geriatrics are indicated. Studying the propaedeutic foundations of geriatrics by doctors of various specialties will improve the quality of medical care for the elderly and senile.

The aim of the study is to develop a technology and method for evaluating the results of medical rehabilitation in patients with fractures of the proximal femur who underwent hip arthroplasty. The article deals with the epidemiology of low-energy fractures of the proximal femur in elderly patients. The sex and age characteristics of this group of patients were determined, the duration of the period from the trauma to the hip joint endoprosthetic surgery was revealed, the presence and significance of concomitant pathology was analyzed. The development of rehabilitation methods was carried out in a personalized manner, based on individual parameters of the patient's health, taking into account the assessment of rehabilitation prognosis, values of the rehabilitation routing scale, using physical, psychological and medical rehabilitation methods. In the course of the study, the dynamics of recovery of the motor function of the organism, compensation of clinical and laboratory parameters, changes in Barthel index and integral rehabilitation scale values were determined; a functional rehabilitation complex was developed and applied, including clinical, physiotherapeutic locomotor, and psychological methods of rehabilitation of patients.

Lower back pain is one of the most common complaints presented by elderly patients during outpatient visits. The reason for this circumstance is the increase in degenerative changes in the musculoskeletal system, in particular, the spine with increasing age of patients, as well as a decrease in the metabolic rate. This situation requires the doctor not only to relieve pain, but also to create conditions for the prevention of relapse of painful sensations. The effect of non-drug treatment methods and, in particular, the use of individual orthopedic correction means on the course of pain syndrome in people with deforming dorsopathy of old age has not been sufficiently studied. In this paper, based on literary data, the effect of the use of individual orthopedic correction means (orthopedic insoles, corsets, bandages) in the long-term period on lower back pain as part of complex therapy of dorsopathy in the elderly against the background of their polymorbidity is shown.

The cognitive reserve allows the human body to cope with the consequences of diseases and brain injuries. However, the predictive ability of cognitive reserve among patients with brain injuries and visual organ pathology regarding motor-cognitive risk syndrome has not been studied in practice. The aim of the study was to evaluate the prognostic significance of cognitive reserve in the prevalence of motor-cognitive risk syndrome after traumatic brain injury and eye injury and ophthalmopathology in old age. To achieve this goal, three representative groups of patients aged 60-74 years were formed: group 1 - patients with eye injury and ophthalmopathology (n=108), group 2 - patients with traumatic brain injury (n=112), group 3 - patients with combined traumatic brain injury and eye injury and ophthalmopathology (n=105). In all groups of patients, the level of cognitive reserve and the prevalence of motor cognitive risk syndrome were determined in the first three days, 1 month later, 3 months later, and 6 months after injury. Regression method and using the program Statistica 10.0 mathematical models have been developed to predict the prevalence of motor cognitive risk syndrome depending on the level of cognitive reserve. It was found that in the first three days after receiving eye injury and ophthalmopathology, traumatic brain injury and combined traumatic brain injury and eye injury and ophthalmopathology, the level of cognitive reserve was 81,5±2,3; 64,1±1,9 and 60,8±1,5 points, respectively, and the prevalence of motor cognitive risk syndrome during this period was 23,1±1,4; 48,2±2,7 and 58,1±2,3 per 100 subjects, respectively (p<0,01). In subsequent follow-up periods, there was a significant increase in cognitive reserve in the first and second groups, but the prevalence of motor-cognitive risk syndrome significantly decreased only after 3 months among patients with eye injury and ophthalmopathology and with traumatic brain injury and remained high and unchanged among patients with combined traumatic brain injury and eye injury and ophthalmopathology (p>0,05). Regression models have been developed for patients with eye injury and ophthalmopathology, traumatic brain injury, combined traumatic brain injury and eye injury and ophthalmopathology to predict the prevalence of motor cognitive risk syndrome depending on the level of cognitive reserve. Consequently, the level of cognitive reserve makes it possible to predict the formation of motor-cognitive risk syndrome.

According to current understanding, aging is a complex process that is influenced by both genetic and environmental factors. Identifying reliable indicators of healthy aging is a significant challenge for modern science. Previous research has shown that aging is linked to a gradual decrease in HRV (heart rate variability). The aim is to analyze age-related alterations in the autonomic control of the cardiovascular system, taking into consideration different variants of the -786T>C polymorphism in the NOS3 gene, based on heart rate variability characteristics. A cross-sectional study was conducted on a sample of 245 northern men, which were divided into three age groups: group 1 - boys (n=109, average age 18,3±0,3 years), group 2 - mature men (n=97, average age 39,5±0,8 years), and group 3 - elderly men (n=39, average age 65,5±1,5 years). The -786T>C polymorphism (rs 2070744) of the NOS3 gene was genotyped using real-time polymerase chain reaction with commercial SNP-Screen kits («Syntol», Russia). Heart rate variability was recorded using the Varicard complex software («VARICARD-KARDi», Russia), and a number of heart rate variability parameters in the time and frequency range were measured. For all heart rate variability parameters that reflect the activity of the parasympathetic branch of the autonomic nervous system, an age-related decrease was observed. However, the rate of this decline varied depending on the variant of the NOS3 gene polymorphism. The maximum decrease in heart rate variability parameters was seen in individuals with the functionally weaker NOS3*C allele (those with TC+CC genotypes). Given the age-related nature of heart rate variability, its use for prognostic purposes necessitates an understanding of normal ranges in different age groups, including consideration of associations with the -786T>C (rs2070744) polymorphism of NOS3 gene. The presence of the TT genotype has been linked to a more favorable, vagus-mediated heart rate variability profile and can be regarded as a predictor for reduced risk of cardiovascular disease.

The use of nootropic drugs is one of the approaches to improving the mental health of older people and preventing at least some cognitive disorders. The study participants were volunteers - conditionally healthy individuals. Volunteers (n=35, average age 53,4±1,21 years) took the phytocomposition «Memoris» 1 capsule 2 times a day for two weeks. Participants in the comparison group (n=35, average age 53,8±1,12 years) received a placebo (maltodextrin). The severity of anxiety/depression was assessed using the HADS questionnaire. A specialized questionnaire to determine well-being, activity, mood was used to assess the psychosomatic state. The quality of life was studied using the standardized SF-36 questionnaire. Under the influence of the phytocomposition «Memoris» statistically significantly decreased the results on anxiety scale (from 7,4±0,64 to 5,7±0,56 points, p<0,001) and depression scale (from 5,9±0,52 to 4,4±0,46 points, p<0,001), increased the results on well-being scale (from 4,9±0,19 to 5,5±0,16 points, p<0,001), as well as mood scale (from 5,5±0,16 to 5,8±0,16 points, p=0,009). After taking the phytocomposition «Memoris» an increase in scores was registered in all categories of the SF-36 questionnaire. Thus, the obtained results indicate a positive effect of the phytocomposition «Memoris» on the indicators of anxiety and depression, well-being, mood and a significant increase in the quality of life of respondents.