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

Along with increasing life expectancy and aging of the population, there is an increase in the incidence of age-related macular degeneration (AMD), which often leads to blindness or irreversible vision loss and has a pronounced impact on the quality of life. Application of an extended complex of diagnostic techniques in ophthalmologic practice in order to expand the possibilities of early diagnosis and prognosis of the disease is urgent. Screening examination of patients with AMD was carried out. The technology of registration of global rhythmic activity of the brain with narrow-band filtering and long summation time was applied with the allocation of mainly long-lasting rhythmic oscillations in the frequency spectrum of 0,1-30 Hz. The peculiarities of the state of autonomic receptors of the eye in AMD have been determined. The prognostically significant signs of changes in the spectrum of the brain activating system at early and late stages of AMD were identified. The information characteristic of the weight of the sign of AMD development was obtained; that allowed to distinguish the ophthalmologic status of patients with AMD. The use of functional-topical diagnostics based on spectral analysis of rhythmic brain activity can be used as an additional non-invasive diagnostic screening test for early development of AMD, which will ensure timely and competently prescribed treatment and allow to achieve better long-term clinical outcomes.

This review presents a targeted examination of the application of comprehensive geriatric assessment tools across various cardiovascular pathologies, including acute coronary syndrome, myocardial infarction, acute and chronic heart failure, and aortic stenosis. It has been demonstrated that assessing patient frailty in cardiovascular pathology is crucial for determining both short-term and long-term prognosis, as well as for evaluating the risk of various complications during cardiac surgical interventions. Currently, there is active research into necessary measures aimed at improving outcomes in frail elderly patients with cardiovascular diseases, such as interdisciplinary rehabilitation and geriatric approaches. Frail patients with cardiovascular diseases should be considered as requiring a personalized approach in the provision of cardiological care, with a deep understanding of geriatric issues in the elderly, to reduce complications and improve prognosis.

Research on the condition of the lungs in senile people is an urgent task. This is due to the fact that degenerative or age-associated changes in the respiratory system play an important role in the formation of senile asthenia syndrome and a decrease in the age-related viability of the body as a whole. CT-scans of patients aged 80-90 years were analyzed (n=31). Age-associated changes were evaluated: the presence of linear fibrosis, increased pulmonary pattern by the type of reticular (reticular) changes, the presence of gross fibrous reticular changes with cystic cavities and air bullae (by the type of «cellular lung»), as well as the presence of pulmonary emphysema. Most naturally, senile people show changes characteristic of linear pulmonary fibrosis and emphysema. The progression of the process leads to diffuse reticular changes in the interalveolar and intersegmental septa and, in adverse cases, to the formation of gross changes in the type of «cellular lung». Fibro-emphysematous changes are significantly more common in men. A microbiological study of the microbiota of the lower respiratory tract in elderly people was also carried out (n=16). When studying the microbiocenosis of the lower respiratory tract in elderly people, the following data were obtained: resident microflora was found in 71% and clinically significant microorganisms were found in 29%.

The aim of the study is to optimize the cognitive abilities of elderly and senile patients during the implementation of a neurocognitive rehabilitation program. A neurocognitive rehabilitation program was developed, during which 729 patients aged 60-89 years (average age 72,5+5,7 years) participated. The program is standardized and consists of three consecutive segments: 1 week - diagnostic segment, 2-5 weeks - main rehabilitation segment, 6 weeks - final. The proposed model of neurocognitive rehabilitation in elderly and senile patients with mild cognitive decline leads to a statistically significant improvement in cognitive status as a key goal of rehabilitation according to the mental function assessment scale in dementia risk groups: in the 1st group - from 24,3±0,4 to 27,2±0,4 points, in the 2nd group - from 25,1±0,3 to 27±0,2 points, in the 3rd group - from 24±0,3 to 27,3±0,2 points; according to the Montreal cognitive function assessment scale: in the 1st group - from 22,3±0,4 to 27,3±0,3 points, in the 2nd group - from 21,8±0,6 to 27,1±0,2 points, in the 3rd group - from 21,7±0,7 to 26,9±0,5 points. The developed and proposed model of neurocognitive rehabilitation for the elderly and senile has pleiotropic effects in the form of reducing anxiety and depression, improving sleep quality and stabilizing geriatric status.

Sarcopenic obesity and visual impairment are considered as two interrelated age-associated conditions that increase the risk of decrease in instrumental activity in everyday life. However, the latter was practically not analyzed in patients with combined sarcopenic obesity and visual impairment due to age-related pathology of the visual organ. The aim of the study was to assess the effect of sarcopenic obesity and age-associated pathology of the visual organ on the functional abilities of patients. 132 patients with sarcopenic obesity and 134 patients with sarcopenic obesity and age-related macular degeneration were examined. The detection of sarcopenic obesity was carried out according to the criteria of reduced muscle strength (or grip strength), reduced muscle mass and increased body mass index (EWGSOP2, 2018). Age-related macular degeneration was diagnosed based on clinical recommendations. Instrumental activity in everyday life was determined by the Lawton scale. It was found that sarcopenic obesity and age-related macular degeneration reduce instrumental activity in daily life to a greater extent (M=4,72±0,07 points) than only sarcopenic obesity (M=5,91±0,09 points), p<0,001. The greatest differences between the groups in the deterioration of instrumental activity in daily life were observed in such types as making phone calls - 0,57±0,05 points among patients with sarcopenic obesity and age-related macular degeneration and 0,89±0,07 points among patients with sarcopenic obesity by 1,56 times (p<0,001), shopping - 0,62±0,06 and 0,76±0,08 points (p<0,01), financial performance - 0,48±0,05 and 0,61±0,04 points (p<0,001), respectively. Therefore, according to these restrictions, patients with sarcopenic obesity and age-related macular degeneration need outside help.

Modern biogerontology considers cellular aging (senescence) as one of the main causes of general aging of the body. Any cell in the body can become senescent due to damage caused by both internal and external factors. Such cells can appear at the earliest stages of development and persist for many years. Due to the emergence of new highly effective research methods, significant progress has been made in recent years in studying and understanding the molecular mechanisms leading to senescence, as well as the effect of senescence on surrounding healthy cells in vitro and in vivo. The results of scientific studies presented in this review convincingly indicate that modern concepts of the pathogenesis of osteoarthritis cannot be formed without taking into account the role of senescent cells and such a process as inflammaging - progressive chronic sluggish systemic inflammation. In recent years, osteoarthritis has come to be considered as a process combining trauma and inflammation, since the key role of cytokines and immune cells in its pathogenesis has been established. Inflammaging is associated with increased numbers of senescent cells in osteoarthritic cartilage that secrete the aging-associated SASP phenotype. The proinflammatory environment initiated by SASP factors promotes cartilage degeneration and subchondral bone remodeling, ultimately leading to loss of cartilage function, osteoarthritis development, and disease progression.

The purpose of this review is to demonstrate the importance of using a comprehensive geriatric examination in cardiology, including geriatric aspects of the management of this patient population. Until now, the Russian Federation has completely lacked a geriatric approach to the management of cardiological patients, which provides for consideration of international experience in this survey. The curation of elderly and elderly patients is complicated by the presence of geriatric syndromes and age-associated diseases leading to deterioration of quality of life, repeated hospitalizations, disability and risk of death. The leading geriatric syndrome in geriatric practice is senile asthenia and multiple comorbid polymorbid pathologies of the geriatric patient. A patient admitted to an acute care hospital with a history of cardiovascular comorbid pathology is primarily viewed as a patient at high risk for cardiovascular complications, omitting the risk of adverse outcomes, including loss of independence and impaired functional status. The following literature review demonstrates the importance of defining senile asthenia outside of the geriatrician's office, justifying the need for advanced training for cardiologists in geriatrics.

The significant prevalence of periodontal diseases in elderly patients makes the research relevant. By now, the issues of complex clinical and radiological semiotics of generalized periodontitis using high-tech research methods is not sufficiently studied. The research addressed the clinical picture and three-dimensional computed tomographic semiotics of severe chronic generalized periodontitis focusing 25 elderly patients with severe chronic generalized periodontitis. It verified the necessity to use an organ-oriented program of multiplanar (volumetric) cone-beam computed tomography coupled with the analysis of the research results, as well as a mandatory analysis of densitometry indicators of the jaw bone tissue in diagnostically significant periodontal zones.

This article presents the incidence of geriatric syndromes in patients with chronic heart failure 65 years of age and older, depending on cognitive status. At the Russian gerontological center, 149 people with confirmed chronic heart failure were selected according to the European criteria of 2021. In this sample, 50,3% of patients had mild cognitive impairment, and 17,5% had severe cognitive impairment. With age, the incidence and severity of cognitive impairment increased. Among patients with cognitive impairment, there were more patients with reduced basic and instrumental activities of daily living, with a high risk of malnutrition and malnutrition, frailty and patients with hearing loss. Also, as cognitive functions declined, the median score of the Barthel and Lawton index, the mini nutritional assessment, the short physical performance battery, the Lubben social network scale decreased, and the median of the Morse fall risk scale and the geriatric depression scale increased. The presence of hearing loss was associated with a 3,6-fold increase in the odds of being diagnosed with cognitive impairment, and the presence of frailty syndrome, basic dependence in daily life, or the risk of malnutrition by a 2,4-fold increase.

Type 2 diabetes mellitus is one of the most common non-infectious diseases in the world. Among people with type 2 diabetes, patients of the older age group. An in understanding of the early cardiovascular manifestations of diabetes occupies an important place in international research and prevention programs, given that cardiac vascular complications are the cause of death in patients with diabetes. Recent studies evaluating left ventricular diastolic dysfunction as a characteristic predictor of diabetic cardiomyopathy by echocardiography. In accordance with the recommendations for diastolic dysfunction, have shown that the algorithm of the informative algorithm is used to determine left ventricular diastolic dysfunction in patients with prognosis in predicting cardiovascular complications.