Vol 32, No 6 (2021)

The paper is devoted to the major vectors of researches in gerontology and geriatrics in the Decade of Healthy Aging (2021-2030), which was announced by the UN and the WHO. It gives the brief characteristics of the basic concepts within which it is necessary to develop medicine and health care for improving care for older people, namely, senile asthenia (frailty) syndrome, individual viability (intrinsic capacity), and age-related viability (resilience).

The paper considers the processes regulating human circadian rhythms. The circadian rhythms are noted to have 2 types of regulation: neuroreflective adenosine and humoral ones due to the hormone melatonin. Information flow in and out of the cerebral cortex has been studied during various types of sleep. It is shown that information flow from the outside is usually impossible, but the reverse flow of information is quite acceptable. Information flow is blocked in the entorhinal cortex. Dreams are noted to be determined by the information contained in cyclic neural circuits (CSCs), the cortical memory cells during their periodic self-excitation. It is noted that the brain does not experience dreams in real time, but creates them on the basis of the information contained in the CNCs.

The quantitative determination of TREC and KREC levels has found wide application in the diagnosis of primary immunodeficiency in the world pediatric practice. The application of the method in the diagnosis of adult patients has remained poorly understood until now. To determine the reference values of TREC and KREC for patients over 17 years old, 140 people aged 18 to 83 years were examined. As a result, the cutoff of the TREC and KREC concentration were determined for whole blood and dry blood stains in patients of the following age groups: 18-24 years old, 25-44 years old, 45-60 years old and over 60 years old.

The average age of the population, as the total life expectancy, is increasing, so the development of measures is relevant to maintain the health and appearance of older people. There is no single algorithm that could characterize the difference between biological age and its visual assessment, despite the fact that cosmetology is developing very actively and in different directions. The paper is devoted to the features of the anatomical and physiological mechanisms of biological aging, to current methods and procedures of anti-age therapy, and to methods for assessing age-related changes.

Often elderly people have severe course of COVID-19 and fast decreasing antibody concentration IgG to SARS-CoV-2. The severe course of COVID-19 may lead to decrease of the life quality and social maladjustment of older age parsons. Thymalin is the immunomodulatory peptide drug with physiological mechanism of activity. The goal of the investigation is to estimate the thymalin influence on the immunogram indicators and antibody IgG к SARS-CoV-2 concentration in elderly patients with COVID-19 on 200th day after treatment. Methods. The control group includes 50 elderly patients with COVID-19 on the standard treatment. The base group consists of 38 elderly patients with COVID-19 on the standard treatment with thymalin applying. Results. It was shown the decreasing of IL-6 blood concentration in 5.95 times to norm level and increasing the number of lymphocytes, CD3+, CD4+ cells in 2.15, 1.95 and 3.73 times to norm level after the standard treatment with thymalin applying in elderly patients with COVID-19 on the 200th day after treatment. The standard therapy has no the same effects. The level of IgG antibody to SARS-CoV-2 on the 200th day after the thymalin applying in addition to the standard treatment was in 4.25 times higher in comparison with this parameter in standard therapy group. Conclusion. The thymalin applying in addition to the standard treatment in elderly patients with COVID-19 normalizes immunogram indicators and prolongs during 200 days the safety high antibody concentration of IgG to SARS-CoV-2, which prevent reinfection. At the same time antibody level of IgG to SARS-CoV-2 in the standard treatment group practically disappeared to the 200th days after hospitalization.

The growth of geriatric syndromes (sarcopenia, senile asthenia, etc.) in the setting of age-related comorbidity has a negative prognostic value for survival of older patients. Early detection of sarcopenia matters muchtoreduce mortality rates among the elderly. Aim. Evaluation of the incidence of comorbidities in patients of mature, elderly and senile age with and without sarcopenia and their impact on mortality and survival rates. Materials and methods. We examined 39 men and 39 women aged between 45 and 89 (average are 60,6±14,3 years). Sarcopenia was diagnosed using the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP) 2010 and the EWGSOP2 2018 recommendations. The comorbidity status was assessed using the Charlson index. Results. Sarcopenia of different severity degrees was detected in 55,7% of the subjects using ultrasound assessment of muscle mass (MM), the incidence of sarcopenia was higher in women that in men (p<0,05). 88,6% of the patients had BMI >25 kg/m2. The mean Charlson index (score) was 6,7±0,3 for sarcopenia patients, and 4,0±0,4 for non-sarcopenia patients (p<0,05). According to the Charlson index, the mortality rate was statistically higher and the survival rate was lower in the sarcopenia group (p<0,05). Conclusion. The prevalence of sarcopenia in patients over 45 years of age in the setting of comorbidity and obesity is up to 55 %, which increases the mortality and decreases the survival rate of patients with concomitant pathologies. Using ultrasound assessment of muscle mass MM, sarcopenia can be diagnosed early to begin preventive measures.

Cognitive impairment (CI) is a common disorder in clinical practice, and it does not result from age-related changes in the normal aging process, in which there is a slowdown in the rate of a reaction and in the pace of activity, information processing, as well as a decrease in the capacity of short-term memory and other features of the cognitive sphere. The prevalence of cerebrovascular diseases in the population is rising steadily and progressively increasing with age; the leading symptom and the earliest manifestation in the clinical presentation of these diseases are vascular CI. Timely detection of CI and adequate therapy and prevention, by taking into account vascular risk factors, are of great importance for elderly and senile patients, since these make it possible not only to slow down the steady progression of the pathological process caused by cerebrovascular disease, but also to prevent obvious disability and poor quality of life.

The quality of life in oncological pathology is an important criterion for the effectiveness of the treatment. One of the key issues is the change in metabolism in the elderly and senile age. This aspect is directly related to the state of the elements. The age-related pathology can also include endocrinopathies, including those with oncological pathology of the endocrine organs. The aim of the study was to develop new approaches to the study of age-associated disorders in individuals with cancer pathology with the study of phosphorus-calcium relationships for their further correction with the goal of improving the quality of life of such patients. We selected 40 cases of prostate adenocarcinoma of the 2nd and 3rd degree in middle-aged and elderly people and 47 cases of papillary thyroid cancer. A clinical and pathomorphological study of the removed thyroid and pancreas was performed (macroscopic, microscopic, electron microscopic in a scanning microscope «FE1 Quanta 200 3D» with a matched detector for the study of elemental analysis). When studying the biochemical atypism in pancreatic and thyroid cancers using point analysis of elements, it was shown that in the areas of accumulation of tumor cells, there was an increase in the content of both calcium and phosphorus, which decreases as they move away from them. Given that their content is higher in the elderly groups and atypical cells are not always identified next to them, it seems that their formation may be primary. The presence of histochemical atypism in the glands can cause the development of paraneoplastic syndromes, in particular, increased osteoporosis in the elderly and a number of other signs. All this should be taken into account when correcting such conditions in order to improve the quality of life.

Understanding the factors that affect the stability of analytes during storage and transport is an important challenge for clinical laboratories. The aim of the study was to study the effect of the age factor on shift of potassium and glucose during storage of venous blood samples. We have carried out a prospective cohort study based on the clinical diagnostic laboratory of the St.-Petersburg State Budgetary Healthcare Institution «City Multi-field Hospital Second». To achieve the goal of the study, 3 groups of 40 samples were formed according to the age of patients. Group 1 - samples of venous blood from patients aged 35 to 59 years (average age is II half). Group 2 - samples of venous blood from patients aged 60 to 74 years old (advanced age). Group 3 - samples of venous blood from patients over 75 years old (old age). The analysis revealed statistically significant differences in the level of glucose shift when comparing age groups 1 and 2, as well as 1 and 3. Shifts of potassium are not statistically significant. The presented research results make it possible to expand the scope of knowledge in the field of the preanalytical stage of laboratory research and in the future can serve as tools for increasing the efficiency and quality of laboratory research.