The paper represents clinical guidelines on frailty, developed by Russian Association of gerontologists and geriatricians. The guidelines are dedicated to geriatricians, internal medicine specialists, general practitioners, family doctors and other specialists, dealing with adult patients. The paper includes screening and diagnostic tools and treatment options for patients with frailty, along with prevention, rehabilitation and medical care organization in this cohort of patients.

The paper represents clinical guidelines on frailty, developed by Russian Association of gerontologists and geriatricians. The guidelines are dedicated to geriatricians, internal medicine specialists, general practitioners, family doctors and other specialists, dealing with adult patients. This publication includes treatment options for patients with frailty.

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Обобщенный термин "артериальная гипертония (АГ) у пожилых" объединяет гетерогенную группу пациентов пожилого (60-74 лет) и старческого (75-89 лет) возраста, а также долгожителей ≥90 лет. Такое обобщение не учитывает, что с возрастом, особенно >80 лет, растет частота развития синдрома старческой астении (ССА, код R54 по Международной статистической классификации болезней и проблем, связанных со здоровьем, 10-го пересмотра, соответствующего термину frailty в англоязычной литературе). Появление и прогрессирование ССА повышает риск развития зависимости от посторонней помощи и ухудшает прогноз пациента; это принципиально меняет приоритеты Лечение артериальной гипертонии у пациентов 80 лет и старше и пациентов со старческой астенией Согласованное мнение экспертов Российской ассоциации геронтологов и гериатров, Геронтологического общества при Российской академии наук, Российского медицинского общества по артериальной гипертонии Рабочая группа по подготовке текста: Ткачева О.

Abstract. Elderly patients are at higher risk of developing infectious diseases that might have more severe progression than those of younger age groups, accompanied by an increased risk of death. These medical conditions in elderly may also present difficulties for diagnosis due to a «blurred» clinical picture. By WHO recommendations the vaccination against influenza is one of the most effective ways to prevent this type of infection in elderly patients. However the use of vaccines may be associated with a risk of adverse drug reactions. In most cases, they have subclinical manifestations and/or non-severe clinical manifestations (adverse reactions), but in a relatively small percentage of cases, the use of vaccines may be associated with a risk of developing serious post-vaccination complications (anaphylaxis, Guillain-Barre syndrome etc.). This article represents data on the safety of influenza vaccines in patients over 60 years old, with due regard to immunosenescence. According to the authors opinion, this will improve the safety of vaccination against influenza patients 60 years and older. At the end of the article, the authors conclude that despite the potential risks, the by the benefits of the use of influenza vaccines continue to overweight potential risks and vaccination of elderly people is effective and safe way to prevent influenza. To improve the effectiveness of vaccination of patients 60 years and older the use of high dose vaccines and adjuvants can be recommended.

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High blood pressure is a risk factor for cardiovascular morbidity and mortality, as well as cognitive decline and loss of autonomy in the elderly and old age. Randomized clinical trials (RCTs) in populations of older patients living at home with low comorbidity and preserved autonomy indicate the benefit of lowering elevated blood pressure in patients over 80 years of age. Older patients with senile asthenia, loss of autonomy and other geriatric problems were excluded from RCTs, and observational studies in these groups of patients indicate an increase in morbidity and mortality with lower blood pressure and antihypertensive therapy. Obviously, in very elderly patients, a universal strategy for the treatment of arterial hypertension cannot be applied due to the significant heterogeneity of their functional status. The geriatric approach to the management of arterial hypertension in older patients involves an assessment of the functional status, the presence of senile asthenia, and the degree of autonomy for the choice of antihypertensive therapy tactics.