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

The inclusion of elderly patients in randomized clinical trials does not reflect the age-related association in coronary heart disease. At the same time, there are few scientific papers devoted to clinical and laboratory factors characteristic of the development of acute coronary syndrome (ACS) in this age category. Timely assessment of clinical and biochemical blood parameters in elderly patients is of great importance in preventing complications that naturally increase in them, significantly affects treatment tactics and the possibility of using generally accepted approaches when choosing drug therapy. From these positions, our study showed the special role of triglycerides and glucose in the development of ACS in elderly patients. A joint assessment of the median serum creatinine (sCr) concentration and the nature of its change during stay in the coronary care unit was carried out, which allowed us to conclude that the stratification risk of mortality was reduced. In patients with ACS, the daily value of sCr and the nature of its change are stronger predictors of hospital mortality than only the initial value of sCr. The results of the study suggest that it is recommended to evaluate serum creatinine to ensure a more accurate and dynamic risk stratification in elderly patients with ACS.

One of the most pressing medical and social problems in the world is the widespread prevalence of chronic age-associated pathology, which includes metabolic syndrome. Metabolic inflammation accompanying metabolic diseases and aging have a common pathogenesis, the basis of which is the activation of the innate immune system and an increase in the inflammatory background. During the aging process, chronic, asymptomatic, sluggish inflammation develops, called inflamaging, which leads to a cascade of pathological changes that disrupt the functions of adipose tissue and the endocrine system, and thereby contributes to the development of a number of diseases. Inflamaging is supported by various stimuli, including pathogens, endogenous cellular debris and defective molecules, as well as excess nutrients. The review examines the common mechanisms of inflammation, aging and metabolic homeostasis disorders, emphasizing the significant role of inflammaging in the development of metabolic syndrome, as well as biomarkers of age-associated diseases, the use of which as targets for therapeutic treatment can help in the fight against metabolic syndrome.

The aging process is associated with a decrease in cardiorespiratory endurance. The profile of changes in hemodynamic parameters, respiratory and metabolic profile during cardiopulmonary exercise testing in the elderly can identify patients with subclinical forms of diseases. It is necessary to develop a standardized approach to the interpretation of parameters that can serve as diagnostic signs of an abnormal response of physiological parameters to physical activity and have optimal prognostic and differential diagnostic value.

There is a worldwide trend towards an increase in the age of first-time mothers. Due to the social peculiarities of society, many women postpone the birth of children after the age of 30-40 years. This often leads to difficulties in conceiving and carrying a pregnancy. Understanding the molecular mechanisms of ovarian aging has important practical significance. Serotonin and its SERT transporter, encoded in humans by the SLC6A4 gene, play an important role in the functioning of the ovaries during various reproductive periods of women's lives. The aim of the study was to evaluate the age-related dynamics of the expression of the serotonin transporter gene SLC6A4 and the synthesis of serotonin in the ovaries at different ages of women's lives. The study was performed on autopsy material from 164 ovaries obtained from people aged several months to 92 years. The synthesis of serotonin in the ovaries was evaluated by immunohistochemistry, and the expression of the serotonin transporter gene was studied by PCR analysis. The level of serotonin in the ovaries of women decreases in aging, reaching minimum values after the age of 45, which may be associated with the onset of menopause. The same age-related trend was found for the expression of the SLC6A4 serotonin transporter gene. These data highlight the importance of serotonin and its SERT transporter for the assessment and development of prevention tools for age-related ovarian changes.

Vitamin C (ascorbic acid) is a key nutrient whose multifunctionality in anti-aging processes remains a subject of intensive research. The relevance of this study stems from the need to systematize data on its dual role (antioxidant/pro-oxidant), mechanisms of action on collagenogenesis, autophagy, melanogenesis, and epigenetic regulation, as well as the development of strategies to overcome its deficiency in the skin-an organ critically vulnerable to age-related and photo-induced changes. The article comprehensively analyzes the causes of localized vitamin C deficiency in cutaneous tissues, which does not correlate with systemic nutritional status, and proposes innovative solutions for its correction. It is demonstrated that reduced ascorbate levels in the dermis and epidermis are linked not only to UV-induced oxidative stress but also to age-related transport impairments exacerbated by the skin's structural barriers. Using mechanochemically synthesized complexes of hyaluronic acid with magnesium ascorbyl phosphate, the efficacy of intradermal delivery is highlighted, ensuring prolonged fibroblast stimulation and extracellular matrix remodeling. Particular attention is given to controversies in classifying vitamin C as an antioxidant: at physiological concentrations, it stabilizes lysosomal pH, enhancing autophagy, while pharmacological doses induce ROS-dependent apoptosis in tumor cells. The review underscores the necessity of personalized approaches in dermatocosmetology and gerontology, utilizing injectable modified ascorbate formulations. The findings hold practical significance for clinicians in developing protocols aimed at correcting age-related hyperpigmentation, stimulating neocollagenogenesis, and preventing aging.

Objective - to assess the association between structural changes in the vertebral arteries and cardiovascular disease risk factors in middle-aged and elderly individuals. The study included 387 patients (196 men and 191 women) aged 45-74 years (mean age 57,7±7,3 years) from a therapeutic profile. Vertebral artery parameters, anthropometric, hemodynamic, and biochemical indicators, as well as the prevalence of cardiovascular risk factors, were analyzed in middle-aged (n=225) and elderly (n=162) groups. Elderly patients had significantly higher mean values of systolic and diastolic blood pressure, serum creatinine concentration, and lower estimated glomerular filtration rate (eGFR) compared to middle-aged patients. The prevalence of arterial hypertension (66% vs. 44,8%, p<0,05), chronic kidney disease (32,1% vs. 18,2%, p<0,05), anemia (27,7% vs. 14,2%, p<0,05), and hyperglycemia (22,2% vs. 5,3%, p<0,05) was significantly higher in the elderly group. A reduction in the internal diameter of the right and left vertebral arteries was observed in 13,7% and 9,7% of middle-aged patients, respectively, and in 13,5% and 4,3% of elderly patients. Vertebral artery diameter correlated with age (r=-0,217), body mass index (r=0,152), red blood cell count (r=0,197), total cholesterol concentration (r=-0,138), low-density lipoprotein cholesterol (r=-0,125), high-density lipoprotein cholesterol (r=-0,129), and estimated eGFR (r=-0,188). In elderly patients, significant cardiovascular risk factors include increased blood pressure, anemia, hyperglycemia, and decreased glomerular filtration rate. To improve the effectiveness of secondary prevention of cardiovascular complications, regular monitoring of hemodynamic parameters, blood glucose levels, and kidney function should be performed, considering the condition of the vertebral arteries.

The paper presents the results of the gut microbiota study in menopausal women with sleep disorders based on different assessments of sleep quality. The study involved 96 menopausal women. Sleep quality was assessed using three questionnaires: the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI), and the Epworth Sleepiness Scale. The qualitative and quantitative composition of the microbiota was assessed using microbiological and molecular genetic methods. In the group with sleep disorders (according to PSQI), molecular genetic analysis of the microbiome revealed an increased content of Enterococcus spp. (p=0,03), Clostridium perfringens (p=0,01), and Shigella spp. (p=0,04). Compared to the control, with moderate sleep disorders (according to the ISI questionnaire), the content of Clostridium perfringens was increased (p=0,02). According to the Epworth scale, a higher content of Bifidobacterium spp. (p=0,04), Prevotella spp. (p=0,02) and Eubacterium rectale (p=0,04) was noted in the group with excessive daytime sleepiness compared to the control. Thus, in menopausal women, the composition and structure of the gut microbiota are associated with sleep disorders.

Cellular aging is one of the fundamental biological processes, which consists of irreversible blocking of cell division under the influence of external or internal factors. The article presents data showing that NF-κB is important in the aging process. Its various functions are associated with the main features of this process, such as changes in intercellular communication, DNA damage, oxidative stress, inflammation, and mitochondrial dysfunction. A stimulating agent activates the NF-κB signaling pathway, and IκB is phosphorylated by IKK kinase (IκB kinase), which leads to IκB degradation. In this case, NF-κB is released from the inhibitory complex, translocates to the nucleus, and activates transcription of controlled genes. Thus, there is evidence of the participation of NF-κB in the processes of aging, carcinogenesis, regulation of proliferation, and apoptosis. However, the role of NF-κB in age-related changes in organs has not been sufficiently studied, and therefore additional research is required.

In this work, the relationship between metabolic syndrome (MS) and the development of cognitive dysfunction is investigated. Both the syndrome itself as a whole and its individual components, analyzed as independent risk factors, were considered. The main attention is paid to the study of potential mechanisms through which MS can have an impact on the cognitive sphere. In particular, aspects such as insulin resistance, dyslipidemia, hypertension, and abdominal obesity were discussed, each of which is capable of affecting brain activity. Based on the analysis of data obtained from various scientific publications, it was found that the available studies give an ambiguous picture of the relationship between MS and cognitive impairment. The difference in results is due to a variety of factors, such as the sample of participants, the methodology of the experiments, and the duration of observations. This makes it impossible to formulate clear conclusions without additional research. However, the results indicate that certain components of the MS may play an important role in the development of cognitive disorders. To obtain more accurate results, large-scale studies with a large number of subjects are required. Such projects will allow for a deeper study of the mechanisms of the impact of metabolic disorders on brain activity, as well as to assess the degree of influence of each component of MS on the development of cognitive disorders. In addition, they will help develop effective strategies for the prevention and treatment of cognitive impairment in MS patients.

Acute myocardial infarction is the leading cause of hospitalization and mortality in elderly patients. The objective of this review is to demonstrate the importance of a comprehensive geriatric examination in cardiology, a balanced approach to choosing a myocardial revascularization method and postoperative patient management. The results of modern studies in emergency cardiology practice were studied and analyzed in such electronic bibliographic databases as Web of Science, Scopus, PubMed, Elibrary. This review presents known surgical strategies for myocardial revascularization, therapeutic options for postoperative management, the impact of geriatric syndromes and COVID-19 on the prognosis and outcome of the disease, clinical and angiographic difficulties in managing elderly patients with myocardial infarction.