Osteoporosis and sarcopenia are age-associated diseases of the musculoskeletal system. Osteosarcopenia, the presence of osteopenia/osteoporosis and sarcopenia. The prevalence of osteosarcopenia in older adults with failing was 37% and associated with higher rate of death. Diagnosis of osteosarcopenia consists of describing medical history of fractures, providing x-ray of the spine (if it is needed) and bone densitometry, calculation of Fracture Risk Assessment Tool (FRAX), evaluating muscle strength, mass, function. The most common exam which is used to measure bone mineral density (BMD) is dual-energy x-ray absorptiometry (DXA or DEXA). Screening using the FRAX is recommended in all postmenopausal women and mеn over 50 in order to identify individuals with high probability of fractures. It is recommended to diagnose osteoporosis in patients with fragility fracture of large bones of the skeleton. Diagnosis of sarcopenia is consist of measures for three parameters: muscle strength, muscle quantity/quality and physical performance as an indicator of severity. Muscle strength can be measured with carpal dynamometry. Muscle mass can be evaluated dual-energy X-ray absorptiometry (program «Whole body»). Muscle function can be evaluated with short physical performance battery (SPPB) tests. In this article described algorithm of diagnosis of osteosarcopenia.
Malnutrition is a common geriatric syndrome, which often undiagnosed, leads to impaired physical and mental functioning and patient prognosis. Geriatric patients admitted to hospital with acute and subacute conditions and pain syndrome are in an especial risk zone. The article presents a clinical case of the development and correction of malnutrition in an 84-year-old patient with aseptic necrosis of the femoral head. Risk factors and existing approaches to the management of patients with malnutrition are discussed.
The present article discusses the perioperative management issues in patients with frailty and other geriatric syndromes focusing mainly on the prevention and correction of malnutrition, ESPEN practical guidelines: Clinical Nutrition in cancer. The concept of prehabilitation is described — a multimodal strategy that is implemented from the moment of diagnosis to surgical treatment, aimed at enhancing postoperative outcomes, which elements have a synergistic effect. The clinical case of 62-year-old female patient prehabilitation with a long-term underweight, prefrailty, sarcopenia, osteoporosis and developed because of a transverse colon tumor malnutrition syndrome is given.
IntroductionThe medical novelty of COVID-19 requires a comprehensive study of its impact on various areas of human health, including mental health.ObjectivesTo study the spectrum and severity of psychopathological disorders in previously healthy patients of different age groups who have had moderate and severe COVID-19 pneumonia.MethodsImmediately after stabilization of the physical condition, patients completed the Symptom Checklist-90-R, designed to assess 11 parameters: somatization (SOM), obsessive-compulsive (OS), interpersonal sensitivity (INT), depression (DEP), anxiety (ANX), hostility (HOS), phobic anxiety (PHOB), paranoid ideas (PAR), psychoticism (PSY). Patients with cognitive impairment were excluded.Results The study involved 148 patients aged from 26 to 84 years. In the general sample, psychopathological symptoms were detected mainly on the SOM, DEP, ANX, HOS scales. To a lesser extent - on the INT and PAR scales; were practically not determined on the PSY and PHOB scales. Most of the symptoms are significantly more intense in patients over 46 years old (n = 129) compared with the younger population (<46 years old, n = 19). Older patients according to SOM revealed 1.23 points (IQR 0.5) versus 0.85 (IQR 0.7) among young people, DEP - 0.88 (IQR 0.44) vs. 0.47 (IQR 0.44), ANX - 0.66 (IQR 0.44) vs. 0.43 (IQR 0.29), OS - 0.55 (IQR 0.5) vs. 0.31 (IQR 0.25) and HOS - 0.46 (IQR 0.34) vs. 0.29 (IQR 0.09).Conclusions Patients recovering from severe COVID-19 pneumonia require psychiatric evaluation and subsequent differentiated psychotherapeutic rehabilitation, especially for the age group over 46.Conflict of interestNo significant relationships.
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