[Continuing work after 64 years of age and postural balance.]

The objective of this study was to assess the components of postural balance among working and non-working men and women aged 65-69. A total of 120 people within the age range of 65-69 were screened. The first group included 30 female and 30 male patients who continued working beyond retirement. The second group comprised 30 women and 30 men who had ceased working by the time of the examination. For comprehensive assessment of postural balance components the computer complex of dynamic postrography «Smart Equitest Balance Manager¼ was used. Sensory Organization Test (SOT) and Motor Control Test (MCT) were conducted. An analysis of SOT and MCT results showed that compared to non-workers aged 65-69, working men and women of the same age range demonstrated more effective maintenance of static and static-dynamic balance, increased postural control performance, including neuromuscular control of balance, as well as optimal balancing and centre of gravity control while maintaining static and static-dynamic balance. The reduced participation of somatosensory, visual and vestibular information in postural control and visual-motor coordination will negatively impact the ability of people over 64 to continue working.

[Older age vitality and retirement (literature review).]

The article provides a review of research literature on the social and psychological peculiarities of working and non-working pensioners with additional new data on their life quality. Six psychographic profiles of pensioners based on their post-retirement activities and motivations for new life path choices were described and examined, enabling identification of the subjects' personality types. These data are essential for psychologists and social workers consulting people approaching retirement age and recent retirees on their retirement lifestyle, ways to organize their working life and effective (creative) pastime, including career development later in life, without sacrificing their physical and mental health. The article looks at the main reasons behind continuing work after retirement thereby supplementing the existing knowledge on post-retirement work motivations. It is important to consider the data obtained when designing public policies on post-retirement work promotion. In its psychological aspect, the process of settling into retirement is similar to the emotional phases associated with the transitional periods of human life. After quitting work, almost all retirees face them in one form or another. Their ability to navigate the process is what will eventually determine how they will spend this stage of their lives. The article analyzes five stages of retirement.

[Concepts of modern gerontology and geriatrics and the role of nutrition in their achievement].

Many factors take part in increasing the healthy period of life - the quality of the environment, drinking water, psychological attitudes in society, dietary patterns, comfort of living, quality of housing, economic relations in the state and society, the degree of landscaping and much more. Collectively, the factors that lead to a healthier and longer life are called the environment that promotes longevity. The scientific study of such an environment, changing everyday life in terms of its quality related to health and increasing duration, is the newest trend in anti-aging medicine. Individual viability (intrinsic capacity) is one of the 4 concepts of geriatrics. The main concept is senile asthenia, the second is premature aging, the third is age viability, which is a psychological state of aging. It seems promising to study the effect of nutrition on individual vitality and longevity. Objective - to study the influence of nutrition on the aging process, to develop further preventive programs based on the data obtained. Methods. Search for literature on nutrition and age problems was held in the databases of RSCI, PubMed, Google Scholar by keywords: aging, ageism, nutrition, individual viability, age-related changes, resilience diet, age-related viability, senile asthenia, domain approach, age. Results. Domain-based assessment is a modern diagnosticis of the condition of people of older age groups, which forms the basis for the development of gerontological preventive programs, in which nutrition plays an important role. Modern studies indicate that the transition in nutrition from «Western¼ patterns to diets with a high content of plant products, as well as fish, vegetable protein (nuts), reduced salt content prevents the development of complications of age-associated diseases by the mechanism of reducing inflammation and hyperinsulinemia, replenishing micronutrient deficiency. Conclusion. Many studies have confirmed the relationship between compliance with optimal nutrition and longevity, as well as a reduced risk of early development of ageassociated diseases. Further research in the field of gerontology will help in the future to develop a comprehensive system of measures aimed at increasing life expectancy and increasing individual viability.

The Clinical Management of Deconditioned Patient.

The current study was designed to investigate the clinical management of deconditioned patients. In the current study, we investigate the clinical manifestations of deconditioned patients. A subacute functional deficiency was determined when getting up from a supine position and developing tachycardia with an increase in heart rate by 30 or more per minute for 10 minutes. This study included 172 elderly patients aged 65 to 74 years. The average age of the patients was 69.2+2.2 years. There were 102 men and 70 women in the study. These patients were registered at the dispensary with the therapists of outpatient clinics after an infectious disease. Within 6 months after the treatment, a comprehensive geriatric assessment of patients was performed. All patients were divided into four groups depending on the indicators of motor activity, which in the framework of this study was the criterion of the adaptive function of the body and viability. Patients with normal motor activity indicators did not have the decondition and were designated as a control group. Patients with the decondition did not have normal indicators of motor activity. The obtained results were processed statistically. According to the results of our study, it was noted that the assessment of the six months after the treatment showed heterogeneity of patients from a functional point of view with a homogeneous somatic structure. Six months after the treatment, out of 172 people, 45 people (26.2%) had normal motor activity indicators (39-40 points); according to the questionnaire "Assessment of motor activity in the elderly", the average score was 39.6+0.2; 42 people (24.4%) had mild motor activity disorders (34-38 points), the average score was 36.1+0.4; moderate disorders (21-33 points) were registered in 47 people (27.3%), the average score was 27.9+2.1; significant motor activity disorders (0-20 points) occurred in 38 people (22.1%), the average score was 13.2+1.4. The fall syndrome was characteristic of those patients with the decondition who demonstrated moderate and significant motor activity disorders 6 months after the treatment. In particular, in people with significant motor activity disorders, there was a decrease in muscle strength in the lower extremities by 48.3+3.2% and in the upper extremities - by 27.1+3.1% (P<0.05). As a result of the presence of the decondition, an unfavorable cascade of geriatric syndromes is formed in the form of an increase in the level of situational anxiety from 21.9-24.8 to 58.4-75.3 points on the Spielberger-Hanin scale, a deterioration in morale with an increase in the severity of depression from 5.8-6.0 to 11.0-14.9 points, a decrease in the quality of sleep on the ten-point visual analog scale from 8.3-8.4 to 5.2-5.7 points on the Beck scale, an increase in the proportion of patients at risk of developing malnutrition syndrome from 4.8-6.7% to 46.8-68.4%, the development of the fall syndrome, which, in turn,, it is a predictor of the development of dinapenia in the form of a decrease in the strength of the upper extremities by 22.7-27.1%, a decrease in the strength of the lower extremities by 29.6-49.6%, with a faster rate of decrease in the strength of the lower extremities compared to the upper extremities by 1.8 times, which, accordingly, reduces the rehabilitation potential. Clinical manifestations of the decondition in elderly patients were such geriatric syndromes as anxiety, depression, cognitive decline, sleep disorders, hypomobility, dinapenia, risk of developing malnutrition syndrome and falls syndrome.

[Characteristics of the coordinated motor response and voluntary shift of the center of gravity in women aged 85-95.]

The objective of this study was to identify the age-related peculiarities of the coordinated motor response and voluntary shift of the center of gravity (COG) in females aged 85-95. A total of 68 women within the age range of 85-95 were screened, mean age (М±SD) - 89,3±3. The first group comprised 37 women between the chronological ages of 85 and 89 (mean age: 86,9±1,6). The second group included 31 women aged 90-95 (mean age: 92,1±1,4). To achieve the stated objective the computer dynamic posturographic complex Smart Equitest Balance Manager (USA) was used. The following tests were conducted: Motor Control Test (MCT), Rhythmic Weight Shift Test (RWS). The tests revealed a decreasing Composite of all Latencies (p=0,009) in the majority of the surveyed women aged 90-95. However, a comparative analysis of the RWS test results showed no statistically significant differences between the age groups. Cause and effect relationships between the RWS test results and subjective perception of aging were established. Women aged 90-95 demonstrated no decrease in the speed of the voluntary shift and effective control of COG in frontal and sagittal planes, whereas the latency of their coordinated motor response was marked by reliably low numbers compared to women aged 85-89. Thus, women after 89 experience no age-related alterations in sensorimotor integration, which could be regarded as a predictor of longevity. The results obtained made it possible to outline the MCT and RWS parameters which can be taken into consideration in forecasting postural alterations and life expectancy for older women.

[Aging foot syndrome: patients screening and routing.]

The article proves that when providing medical and social care to patients of older age groups, it is advisable to pay attention not only to the patients' somatic and geriatric status, but also to perform screening of local geriatric syndromes that affect the patients' functional status, such as, in particular, aging foot syndrome. Implementation of rehabilitation treatment measures that we propose allows to maintain the patients' mobility level and consequently their general functional capability level and quality of life.

[Effect of pharmacotherapy on collagen metabolism in patients with heart failure with middle range ejection fraction of senile age.]

Of particular interest is the study of the mechanisms of development of chronic heart failure, especially with middle range ejection fraction (HFmrEF). In conditions of HF, the significance of the development of myocardial fibrosis increases many times, leading to irreversible dysfunction, which contributes to the further progression of HF. Atrial fibrillation is an additional factor contributing to systolic dysfunction of the left ventricle. The purpose of this study was to study the effect of beta-blockers on changes in fibrosis markers in senile patients with HF, including those with AF. 104 patients with HF, coronary disease of functional class II were examined according to the classification of NYHA, the average age was 78,4±3,2 years. After 12 months, we found a significant decrease in the level of matrix metalloproteinase-type 1, -type 9 (MMP-1, MMP-9), tissue inhibitor MMP-1 (TIMP-1), as well as the ratio of MMP-1/TIMP-1, MMP-9/TIMP-1 in senile patients with HF, including those with atrial fibrillation who took nebivolol as a beta-blocker. While in patients who took bisoprolol, no significant changes in the studied parameters were detected (except for MMP-9). Changes in collagen metabolism cause the restoration of myocardial function after therapy with the beta-blocker nebivolol in patients with chronic heart failure with an middle range ejection fraction, including atrial fibrillation. Serum markers of collagen turnover can serve as a non-invasive method for documenting and monitoring both the degree and mechanisms of myocardial fibrosis in patients with HF, coronary disease, including in the presence of AF.

[Prevention of disoders of activity which associated with the risk of dynapenia and sarcopenia by combined aerobic-anaerobic training.]

The article presents the data of the study of different models of aerobic and anaerobic exercise in 208 elderly people (89 men and 119 women), which were divided into three groups. The 1st group (control) received standard recommendations of the doctor on the regime of physical activity (daily walks of at least 30 minutes). The 2nd group in addition to the standard recommendations received training in the form of Nordic walking with the regime of classes twice per week for 60 minutes. The 3rd group in addition to the standard recommendations received combined aerobic exercise in the form of Nordic walking twice per week for 60 minutes + anaerobic exercises with a frequency of training twice per week for 30 minutes. It was found that the best results of the increase in total activity, improved gait and stability, as well as increased muscle strength were achieved in the 3rd group of patients. Such, combined aerobic-anaerobic exercise can be recommended as a program of geriatric prevention of disorders associated with the risk of dynapenia and sarcopenia.

[Bio-psycho-social model of energizing care of the elderly and senile age at home.]

Due to the introduction of new medical technologies, there is an increase in the number of people, including the elderly and senile age, who have extended their lives, but who need constant care from medical and social services at home. In the study of age differences of biological needs in home care, it was found that for middle-aged people the greatest difficulties and contribution to the reduction of quality of life brought insufficient nutrition, limited independence in the performance of household manipulations due to joint damage, pain and other biological causes, as well as hypothermia syndrome compared with elderly and senile age. For people of older age groups was characterized by the need to bridge the lack of communication; enhancing the role of the family in the implementation of care; increased confidence in caregivers; increased availability of medicines; and increased availability of religious services. Developed on the basis of identified age-based determinants of quality of life, the original model of the bio-psychosocial activating care for the geriatric contingent of patients at home, the difference from traditional approaches is the use of activating kinesitherapy and cognitive exercises, contributes to the achievement of a higher level of functionality and independence of the geriatric patient, which is accompanied by improving the quality of life.

[Preventive geriatrics vs anti-aging medicine].

The article presents the main modern ideas of the new interdisciplinary direction at the junction of aesthetic medicine, geriatrics and valeology - preventive geriatrics, or the anti-aging medicine. Describes its purpose, namely effective individual programs of prevention of the development and progression of chronic diseases and age-related conditions; the overview of the diagnostic methods used in preventive geriatrics, individualized prevention programs with proven efficacy is given. Substantiates the importance of preventive geriatrics (anti-aging medicine) as a discipline with its own scientific methodological tools, points of application, and presents prospects of scientific study.