[Somatic pathology in elderly and senile persons suffering from Alzheimer's disease and Alzheimer's type dementia.]

In order to study the prevalence of chronic somatic age-associated pathology in elderly and senile people suffering from Alzheimer's type dementia with the presentation of the hypothesis of somatopsychic pathogenetic comorbidity observation and treatment, 217 patients were observed, conditionally divided into 2 comparable groups: with a definitive diagnosis of Alzheimer's disease (n=73) and with so-called Alzheimer's type dementia (n=144). Distinct differences in the variants of comorbid to the selected types of dementia of somatic pathology were determined, which had a negative impact not only in terms of the occurrence of cognitive disorders, but also in the future, during the formation of the most severe variants of dementia. In cases of Alzheimer's disease, pathological processes in the large intestine turned out to be leading, with Alzheimer's type dementia - diseases of the circulatory system and type 2 diabetes mellitus. Nevertheless, the diagnostic algorithm of patients with dementia should include the most comprehensive somatic examination, and treatment should affect not only the mental, but also the somatic sphere, taking into account the principles of a comprehensive geriatric assessment. With such approaches and under the condition of social well-being in the family, it is possible to achieve not only stabilization, but also some improvement in terms of psychopathological disorders, in particular with Alzheimer's type dementia.

[The state of the oral cavity in early diagnosis and predicting cognitive disorders.]

A review of the literature on the problem of the use of non-invasive technologies in early diagnosis and prediction of age-associated cognitive decline associated with Alzheimer's disease is presented. The main attention is paid to the study of the buccal epithelium, oral fluid, as surrogate models of degenerative lesions of cerebral structures, as well as determining the role of oral microorganisms in the formation and development of cognitive disorders. An original hypothesis of neurodegenerative lesions of cerebral structures is presented, on the basis of which an algorithm for studying the state of the oral cavity is proposed in order to detect and predict cognitive deficits as early as possible.

Age features of buccal epithelium in practically healthy people.

Recently, buccal epithelium has been used to study age-dependent processes. This approach is of particular relevance due to its non-invasiveness. The purpose of this study is to establish the normal values of the buccal cytogram in different age groups, including athletes. 200 practically healthy volunteers of different ages were examined, who were divided into 5 groups in accordance with the WHO age classification. In addition, 125 professional athletes took part in the study. All patients underwent a comprehensive dental examination and a standard cytological examination of buccal smears. It has been established that the cytological characteristics of buccal epitheliocytes, indirectly reflecting disorders of the nuclear apparatus of the cell, did not change significantly with age, but there was a certain upward trend in the number of cells with such anomalies (micronucleus, protrusions).The number of binuclear cells and the apoptotic index also slightly increase with age. At the same time, a high positive correlation was found between the apoptosis index and senile age. In young athletes, an increase in the number of buccal epitheliocytes with a perinuclear vacuole (an early sign of cell damage) was foundAnalysis of the cytological examination results of the buccal epithelium in people a slight increase in the level of cytological abnormalities in old age, in particular, signs of apoptosis. In addition, in healthy young athletes (18 years old - 44 years old), an increase in the number of cells with signs of nuclear degradation, which most likely reflects increased mechanical stress on the maxillofacial apparatus during sports activities.

Lactoferrin of oral fluid is normal and in Alzheimer's disease: laboratory and diagnostic aspects (review of literature).

The article discusses the clinical value of determining the lactoferrin protein in oral fluid - one of the representatives of the saliva proteome. The review is based on the analysis of modern literature, including systematic reviews, the results of multicenter prospective studies, review and original articles by leading experts in this field, presented in the databases PubMed, Scopus, CyberLeninka. The problems of the preanalytical stage, methods for determining lactoferrin are highlighted and information about its content in mixed saliva according to various authors is provided. Special attention is paid to the clinical and diagnostic value of the level of salivary lactoferrin in Alzheimer's disease. According to most authors, the diagnostic sensitivity of this parameter ranges from 87 to 100%. Some mechanisms of the relationship between this protein and the central nervous system (CNS) are shown. In conclusion, it is concluded that salivary lactoferrin can be an "indicator" of the formation of amyloid plaques and can be considered as one of the reliable biomarkers of Alzheimer's disease. This opinion is based both on fundamental ideas about the global relationship between innate immunity and the central nervous system, and on clinical data. The special advantage of this laboratory test is its non-invasiveness, which makes it more preferable in comparison with the determination of amyloid and tau proteins in the cerebrospinal fluid and blood.

[The dependence of medical and diagnostic measures carried out in geriatrics on age, gender and the doctor's health status.]

The article discusses the probable dependence of the actions of a specialist working with geriatric patients on the age, gender, and other characteristics of this specialist. This seemingly unconventional approach to research in the field of gerontology and geriatrics reveals distinct differences in a number of aspects of clinical thinking and following clinical recommendations in doctors of different ages, genders, and in different states of their own health. On the basis of a survey of 126 doctors and an analysis of 2 394 of their opinions, the results were obtained, indicating a certain conservatism of doctors over the age of 50, especially men with extensive clinical experience. The article discusses cases of so-called self-ageism of an elderly specialist who uses in his professional actions the results of diagnosis and treatment of the age-associated pathology that he himself suffers from. It is proposed in the process of continuing education or professional training of geriatricians to take into account their age, sex and health status, as well as accompany classes mandatory determination of the biological age of the specialist.

[The possibility of using the results of the study of oral fluid and buccal epithelium in the diagnosis of Alzheimer's disease.]

The article presents the results of the first experience of comparative studies of the state of the oral fluid and buccal epithelium in 12 patients suffering from Alzheimer's disease, and in 12 individuals without any signs of cognitive impairment. In the course of the study, the correlative relationships of pro-inflammatory and anti-inflammatory factors of the oral fluid, the main cytological changes of the buccal epithelium with the results obtained during neuropsychological testing using the MMSE and ADAS-COG scales were studied. This comparative study is associated with the assumption of a common ectodermal origin of the nervous tissue and buccal epithelium, which may be due to systemic pathological changes in the tissues of a single embryonic embryo leaf. The results obtained indicate the specificity of pathological changes in the oral fluid and buccal epithelium for Alzheimer's disease, which allows us to use the study of these materials to obtain additional diagnostic markers of this disease.

[Cognitive aging and cognitive reserve: point of contact.]

The high risk of cognitive disorders in the elderly and senile age makes, on the one hand, to look for their causes, on the other - the possibility of prevention. In this regard, in recent years, the concept of cognitive reserve has become widespread, implying a set of quantitative parameters of the brain and its ability to maintain high functional activity in the process of aging and against the background of age-related brain pathology. The material presented in the article on the basis of the review of scientific literature highlights two main points concerning the possibility of preserving the cognitive reserve-gender and educational factors. It is pointed to the different opportunities of women and men associated with the structural and functional characteristics of the Central nervous system in representatives of different sexes and the special role of the educational process supported throughout life. The author's position on the need to separate the concepts of education and the level of General culture, and the creation of a convenient tool for determining the latter is indicated. This, in turn, would help in the development of a cognitive reserve model aimed at preventing the transformation of physiological cognitive aging into pathological aging.

[Age-associated cognitive impairment and intestinal microbiota: state of the issue and prospects for further study.]

In recent years, the relationship between the microbial flora of the gastrointestinal tract, mainly the intestinal microbiota, and the state of various brain structures responsible for cognitive functioning has been actively studied. Special attention is paid to the transformation of the intestinal microbiota during aging and against the background of age-associated pathologies such as Alzheimer's and Parkinson's diseases. The material presented in the article, based on a review of the scientific literature of recent years, highlights the main points of interaction between the intestinal microbiota and the Central nervous system in the conditions of norm, pathology and age dynamics. The article deals with the participation of intestinal microflora in the pathogenesis of cognitive disorders and the possibility of using probiotic-based drugs in the complex therapy of neurodegenerative diseases in the elderly. The author's position is indicated in terms of the need for further study of the problem, taking into account its gerontology significance and possible disorders of the gastrointestinal tract when using medications for the treatment of dementia.

[Possibilities of application of remote educational technologies in the training of doctors on gerontology and geriatrics.]

The article raises a very important problem devoted to the possibility of using distance learning technologies in the system of postgraduate training of doctors in gerontology and geriatrics. In the comparative aspect, the advantages and disadvantages of distance education are given, the possibilities of their application in different variants of training a geriatrician doctor with different duration of training cycles are evaluated. The problem is considered from the point of view of the doctor, his employer, representatives of the educational organization taking into account the existing normative, legislative acts. The results of the studies performed at the medical University. Recommendations aimed at improving the programs of postgraduate training of geriatric doctors and other specialists solving medical and medical social problems of the elderly and senile age with the use of remote technologies are presented.

[The Actuality of Inter-Sectoral Interaction in Development of Mechanisms of Healthy Aging].

Nowadays, issues of healthy aging are actual for all EU countries. The increasing of percentage of population of elderly age during last decade issues a challenge to national governments in various economic sectors concerning development of mechanisms favoring decreasing of economic burden of diseases, social and psychological problems of aging population and supporting health preservation in elderly age.

[Characteristics of anxiety in patients of older age groups with different types of mild cognitive disorder]. / Osobennosti proiavleniia trevogi u patsientov starshikh vozrastnykh grupp s raznymi tipami umerennogo kognitivnogo rasstroistva.

AIM: To study the structure of anxiety symptom complex in patients of older age groups with amnestic, disregulatory and polymodal types of mild cognitive impairment (MCI) and determine the clinical efficacy of 2-ethyl-6-methyl-3-hydroxypyridine succinate (mexidol). MATERIAL AND METHODS: Thirty-two patients over 55 years of age with MCI (ICD-10 item F 06.7) seeking medical help due to anxiety were included in the study. Inclusion criteria were the compensation of concomitant diseases, absence of relevant stressful events during the last year, absence of depression. Clinical-psychopathological method and psychometric scales (HAM-A, GDS, MMSE, CGI-S, CGI-I) and a stressful life events list were used. Reduction of the total score on the HАМ-А was the main criterion of the efficacy of 4-week treatment with mexidol (375 mg daily). RESULTS AND CONCLUSION: At baseline, mean scores on the HAM-A and MMSE were 39,9+3.18 and 25.7+0.6 respectively. The study of the anxiety structure in patients with amnestic, disregulatory and polymodal types of MCI revealed the different phenomenology of anxiety symptom complex. Repeated assessment of anxiety on the HAM-A was performed on 1, 2 and 4 week of treatment with mexidol. The improvement of mental state was noted in all types of MCI but the better results were obtained in disregulatory and polymodal types. The rate of anti-anxiety effect was higher in the disregulatory type of MCI. In all patients, mexidol improved attention stability and autonomic function.

[Medical, psychological, social and gender aspects of aging in modern Russia].

In this article, the authors considered controversial issues ambiguous attitude to the aging process of the population of the Russian Federation on the basis of a number of individual differences--psychological, social, sexual, and medical. The thesis is that, unfortunately, the fight against aging appears rather to be more a struggle with an already existing old age, and you need to develop preventive measures against aging much earlier than is currently done. Submissions own research confirm this position. The system of training, adjustment to a new level of life, to the new conditions associated with aging process, in the form of a special kind of multidisciplinary centers that carry out the tasks of improving health and young is proposed.