[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 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.

[Indicators of the hormonal spectrum in the acute period of stroke in representatives of different gender and age with different degrees of severity of functional disorders.]

The level of serum levels of a number of hormones in the acute period of stroke was determined in 29 men and 29 women aged 45 to 88 years. Comparison of the results obtained was carried out in relation to the age of the patients and the severity of the functional defect formed at the end of the acute period of stroke. The most pronounced dynamics in relation to different severity of functional disorders was found for cortisol, aldosterone and estradiol (p=0,014-0,022) in men under the age of 60 years and for testosterone (p=0,001-0,0001) in men 60-88 years. In women over the age of 60 years parallel to the increasing severity of the functional defect is only significant increase in the concentration of prolactin in the blood (p=0,02), the dynamics of the other components of the hormonal spectrum did not show any statistically significant dependence on age and functional outcome of acute stroke. It is concluded that some hormones are actively involved in the formation of post-stroke functional defects, and the level of their content in the blood serum in the acute period of stroke can be considered as prognostic criteria for acute cerebrovascular pathology. However, the present differences in the dynamics of the hormonal spectrum in representatives of different ages and genders indicate the need to personalize diagnostic and therapeutic measures in gender and age aspects.

[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.

[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.

[Syndrome of emotional burnout among women-physicians elderly].

The article presents the results of a comparative study of clinical symptoms of syndrome of emotional burnout among 84 working in the specialty physician of older women and 48 officially ceasing operations in this specialty. The findings suggest that burnout can take place among representatives of older age and more it is continued, provided professional activities. The cessation of the work activities leads to stress, often with the subsequent development post-traumatic stress disorder and stress-induced diseases. However in this case the clinical symptoms of the syndrome of emotional burnout, does not disappear, but only happens their clinical transformation attach various psychosomatic disorders. Thus, the elderly, suffering the syndrome of emotional burnout, are at high risk group with regard to the formation and development of diseases, associated with stress and require close monitoring in the framework of the compulsory program of medical examination.

[The formation and dynamics of cognitive disordersin acute period of stroke in representatives different ages.]

In a sample of 116 patients aged 23 to 82 years was conducted study of the state of the cognitive sphere in the final stage of the acute period of ischemic and hemorrhagic stroke. Signs of cognitive deficits were detected in 80 (70%) of them, often over the age of 60 years and against the background of ischemic stroke. But only 8,6% of the representatives of elderly and senile patients disorders of cognitive functions are first diagnosed on a background of stroke. The majority of elderly patients they mentioned earlier, and the stroke only caused further progression of cognitive deficit. Due to the age and background of stroke, cardiovascular disease negative impact on the cognitive functions, especially in ischemic stroke. However, hypertension can help to reduce the volume of the ischemic lesion and thus prevent the development of severe cognitive disorders. Surgical intervention was performed due to stroke, can contribute to the formation and progression of cognitive impairment, and thrombolytic therapy, on the contrary, reduces the risk of cognitive deficit. Continued employment in retirement age has a positive effect on maintaining cognitive functions.

[Comparative analysis of different methods of geroprotective].

In the monitoring process 110 representatives of different age groups held a comparative analysis of the efficacy and safety of several geroprotective techniques, including the use of dry carbon dioxide baths, hyperbaric oxygen therapy, therapeutic massage and receiving Oligopeptide preparations containing complexes lysyl-glutamyl-asparagin and glutamyl-asparagin-arginine (Vezugen and Pinealon). The most pronounced positive impact on indicators of biological age were detected during the combined use of these two Oligopeptide complexes. The most safe from the point of view of influence on a number of biochemical, immunological parameters, clinical condition of the patients were therapeutic massage and Oligopeptide drugs. The use of dry carbon dioxide baths and hyperbaric oxygenation with an undoubtedly positive influence on the indices of biological age has a number of limitations and contraindications regarding its security.

[Age and gender aspects of the status of lipid profile and stress-realizing systems of the human body in the aging process].

In the course of inspection 1136 persons of different age and sex data on dynamics of the main components of lipid profile, the concentration of brain-derived neurotrophic factor (BDNF) in blood plasma and indicators of levels of free cortisol, melatonin sulfate, metanephrine and normetanephrine in urine daily were obtained. Clear age and gender differences related both to the content of atherogenic fractions of lipids in the blood, and types of dyslipidemia were revealed. Fundamental differences in the age dynamics of indicators of stress-realizing systems in men and women and the correlation of these indicators with the level of low density lipoproteins and atherogenic coefficient were identified. The data obtained may indicate different mechanisms of development of atherosclerosis and its associated pathological aging in people of different sex and age, which enables the practical use of research results for the earliest diagnosis and prognosis of a number of associated with age and pathological conditions.

[Clinical and pathogenetic features of ischemic stroke among representatives of different gender and age].

We observed 1410 patients of different gender and age with ischemic stroke of 4 main clinical and pathogenic types - atherothrombotic, cardioembolic, hemodynamic and lacunar. The dependence of the pathogenic type of stroke, background options for stroke pathology and risk factors of stroke on sex and age of patients was analyzed. We founded out that atherothrombotic ischemic stroke is more common for persons of retirement age, and in working paeople - gap and hemodynamic once, although atherothrombotic strokes in this age group were more frequently observed among men. The importance of hypertension in the development of ischemic stroke reduces with age, but the role of cerebral atherosclerosis, ischemic heart disease and cardiac arrhythmias increases. As risk factors for ischemic stroke in the pension age physical inactivity, overweight and dyslipidemia play the main role, when reducing the role of smoking and stress, more relevant for working people. The frequency of the presence of certain risk factors and background for ischemic stroke disease depends on the patient's gender, but in different age periods and under different pathogenic types of ischemic stroke this dependence changes and in people of retired age it is less distinct than in working people.

[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.

[Comparative biochemistry of process of ageing in men and women].

In the research of a number of biochemical indicators in 858 men and 899 women aged from 20 till 70 years divided into 6 compared groups depending on age and gender clear distinctions in the dynamics of the components of the lipid status, status of lipid peroxidation and antioxidant activity of the blood system, the content of middlemolecular peptides are revealed. Simultaneous determination of the biological age of the subjects also revealed a distinct gender differencies testifying to lower rate of aging of men, despite the probability of earlier, in comparison with women, development of dislipidemia and atherosclerosis. Association of the received gender distinctions both with changes of level of estrogen in women due to menopause and with the peculiarities of stressful impacts on male and female organism in different age periods is supposed.

[Dynamics of health and aging rate of patients of different age and sex in the treatment of moderate multiple pathologies].

The article presents results of investigation of the dynamics of health status of patients of different age and sex, with several non-serious diseases, in the course of their treatment in the hospital, as well as the determination of their biological age before and after the course of treatment. The clear differences in the number of diseases, their nature, duration of the treatment and its effectiveness depending on age and sex were revealed. However, at the age of older than 60 years these differences gradually disappearing. Multiple, although non-serious, pathology has a negative impact on the indicators of the biological age of men in the calendar age of 20-39 years and women in the calendar age of 20-39 and older than 60 years, but the rejuvenating effect of the treatment is extremely low. In a number of cases, in the process of treatment of multiple pathologies the indicators of initially reduced biological age get even higher and adapt to the indicators of the calendar age. The authors explain this from the position of the disturbed by the treatment adaptation of the organism to easy disease, as well as the opportunity of reviewing the biological age significantly reduced in relation to the calendar age as a pathological phenomenon similar to significantly increased biological age.

[Treatment of elderly and senile patients suffering from benign prostatic hyperplasia and chronic prostatitis].

In the clinical settings and in animal experiments the research was conducted on effectiveness and safety of treatment the benign prostatic hyperplasia, chronic prostatitis in the stage of active inflammation in elderly and senile patients. The method of treatment including transrectal fonoforez of the Russian preparation of Tisol (Tisolium, gel, the company "Olympus" Yekaterinburg) in combination with diclofenac sodium protected by patents of the Russian Federation was used. The developed method of treatment has shown high efficiency and safety, which is confirmed by experimental, clinical, laboratory and instrumental studies.

[Depressive disorders in elderly and senile patients in the period of rehabilitation after acute ischemic stroke].

To definite the probability of occurrence of depression after suffering an ischemic stroke in elderly and senile age and the impact of depressive disorders on the results of the rehabilitation treatment the comparative study of 186 patients aged over 70 and 110 patients at the age of 33-60 years was carried out. The results testify that the frequency of occurrence and severity of post-stroke depression do not depend on age. But the depression has a more significant impact on the results of the rehabilitation treatment in the elderly than in patients of the young and middle age, which is explained by a long existence in the period prior to the stroke of the emotional-volitional disorders, characteristic for the elderly and senile age. Expressed motor disturbances as the results of a stroke in elderly and senile age are quite rarely contribute to the development of depression, although a combination of severe paralysis with depression has a negative impact on the results of rehabilitation in older patients. Speech and pelvic disorders are not the triggers for depression and do not have negative influence on the results of restorative treatment of patients of elderly and senile age; the situation is opposite in younger patients.

[Features of bioelectric activity of the brain in epilepsy patients of elderly and senile age].

89 patients of elderly and senile age with various epilepsy forms have been examined. The general characteristic features of bioelectric brain activity of the elderly patients, suffering from epilepsy have been defined. Features of electroencephalographic (EEG) picture depending on the form of the disease, age of debut, expressiveness of cerebrovascular pathologies are revealed. It is shown that the survey of EEG in dynamics helps with selection of adequate antiepileptic therapy and enables to avoid strengthening cognitive deficiency.

[Efficiency of rehabilitation of elderly and senile patients after an ischemic stroke].

Productivity of a wide medical rehabilitation in 296 patients who have had an ischemic stroke was studied. In the period of rehabilitation treatment 186 patients of 70-84 years composed the basic group, 110 in the control group were of 33-60 years. Clinical, social, psychological indicators in dynamics were compared; results of variety of tool and laboratory researches were estimated. Possibility of high efficiency of medical rehabilitation in elderly and senile age is stated. This efficiency depends on expressiveness of impellent defect, the period of a stroke, somatic diseases and on depressive infringements. Positive shifts in character of bioelectric activity of a brain and also activation of non-vascular link of a cerebral metabolism in comparison with vascular one can serve as prognosis criteria of success of rehabilitation of the elderly.

[Current problems in mutual relations of cerebral vascular and cardiovascular diseases in elderly and senile age].

The authors have been taking up the problems of the cardiovascular pathology caused by atherosclerosis for many years, and are supporters of universality of the specified pathology. The article demonstrates the results of the researches executed by authors, and other leaders of this direction in a medical science. Questions of mutual relations of various diseases of cardiovascular system on clinical, pathogenetic, pathomorphological, biochemical levels are considered. Aging of a human body, and also brain and heart vessels as leading "targets" of the atherosclerosis are supposed to be a pathogenetic basis of formation and development of universal atherosclerotic defeat processes. Therefore the gerontology plays a prior role in studying the strategic aspects of this field of a medical science, and tactical questions of diagnostics and treatment of cardiovascular diseases should be a prerogative of clinical disciplines, namely cardiology, neurology, cardiovascular surgery, etc.

[Clinical and pathogenetic characteristics of the craniocerebral trauma received by elderly patients after stroke].

In 174 patients of elderly and senile age features of a clinical picture and pathogenesis of a craniocerebral trauma of a different severity occurred in different terms after the previous stroke and in different circumstances have been studied. The mutual relations of traumatic and vascular processes are complex, the vascular pathogenetic features of a trauma influence actively to the brain, earlier damaged by an ischemic stroke, increasing the probability of the heavy form of a combined cerebral pathology and the unfavourable forecast. However the vascular encephalopathy in these conditions "does not develop" in posttraumatic one and chronic vascular-brain frustration absolutely prevail in all cases above traumatic ones. This fact is to be taken into consideration to further treatment and rehabilitation.