Elena Frolova | Северозападный государственный медицинский университет им. И.И.Мечникова (original) (raw)
Papers by Elena Frolova
Russian Family Doctor
The article analyzes the features of teaching geriatrics in the modern world on the example of th... more The article analyzes the features of teaching geriatrics in the modern world on the example of the educational project “Annual Spring School of Practical Geriatrics”, proves the need to use innovative techniques for effective and rapid training of geriatrics, in accordance with the needs of society and official government documents.
Russian Family Doctor
In this review the information is presented about new clinical guidelines on arterial hypertensio... more In this review the information is presented about new clinical guidelines on arterial hypertension, syncope guidelines, about screening of atrial fibrillation and antithrombotic and anticoagulants usage according clinical trials data. Attention is payed to digital technologies in health care sector. This information is based on data of European Cardiology Congress 2018.
Russian Family Doctor
The article presents the results of modern research regarding the mechanisms of the positive effe... more The article presents the results of modern research regarding the mechanisms of the positive effect of physical activity on cognitive functions, the benefits of aerobic exercise, and recommendations on physical activity for older adults with cognitive impairment.
Russian Family Doctor
Atrial fibrillation (AF) is the most common rhythm disorder. The consequences of undiagnosed AF a... more Atrial fibrillation (AF) is the most common rhythm disorder. The consequences of undiagnosed AF are an increased risk of developing of heart failure and thromboembolic complications. The article is devoted to study of the possibility of using the medical device MyDiagnostick 1001R® in clinical practice for patients with the risk of AF development for early stage diagnosis. Methods. A group of subjects included 30 patients who did not have a history of AF, but who had the risk factors for its development — arterial hypertension, diabetes, obesity, ischemic heart disease (IHD). The average age of participants was 65.9 ± 12.1 years. A questionnaire containing 16 questions was developed to identify the risk factors of AF development. Results. From 30 participants 80% had arterial hypertension, 43.3% diabetes, 3.3% were obese, 50% suffered from IHD, 16.6% had stroke in anamnesis and 23.3% were smokers. All patients had a combination of risk factors. As a result, with the help of MyDiagno...
Russian Family Doctor
Due to the low detectability of atrial fibrillation (AF), more attention is paid to AF screening.... more Due to the low detectability of atrial fibrillation (AF), more attention is paid to AF screening. Screening procedure requires new diagnostic devices that allow immediate assessment of heart activity. One such portable device is the MyDyagnostick 1001R. The aim. Сomparison of the clinical effectiveness of screening in people who participated in the preventive health examinations and in patients with AF risk factors admitted to the City geriatric medical hospital. Materials and methods. 101 patients hospitalized to City geriatric medical center were included using the method of continuous selection. Another sample of patients included 102 volunteers who participated in a preventive health examinations organized by the City center for medical prevention in St. Petersburg (convenience sample). Heart activity was registered with portable device MyDyagnostick 1001R. Results. AF was diagnosed in 25 (24.8%) patients from geriatric medical center were. Of these, 12 patients were not suspect...
Russian Family Doctor
Анализируя научную и образовательную деятельность кафедры семейной медицины СЗГМУ им. И.И. Мечник... more Анализируя научную и образовательную деятельность кафедры семейной медицины СЗГМУ им. И.И. Мечникова, автор обосновывает необходимость нового подхода к обучению гериатрии, базируясь на опыте научных исследований, проведенных и продолжающихся на кафедре. Ключевые слова: общая врачебная практика, научная деятельность, гериатрия, обучение, инновационное обучение. On the basis of analysis of scientific activity of department of family medicine the author discusses the need of new educational technologies, especially in geriatrics. As an example of research based education new educational activities used the results of the Crystal study are described.
Russian Family Doctor
The results of investigation of sample of 107 patients 60 years and older during one month are de... more The results of investigation of sample of 107 patients 60 years and older during one month are described. This sample was collected in geriatric outpatient departments. The prevalence of geriatric syndromes was assessed. The main geriatric syndromes revealed were high risk of falls, risk of malnutrition, depression and cognitive disorders. 67% of patients were frail. All geriatric syndromes caused high level of dependency. The geriatrician made recommendations for correction of main problems. All recommendations need to use multidisciplinary approach.
Russian Family Doctor
Chronic heart failure (CHF) is the most frequent and severe complication of cardiovascular diseas... more Chronic heart failure (CHF) is the most frequent and severe complication of cardiovascular disease (CVD). One of the most important aspects of management of patients with CHF remains to ensure adherence to treatment. The purpose of the study was to assess the effectiveness of therapy of patients with CHF with the use of a diary of self-control as a way of enhancing adherence to therapy. Materials and methods. A continuous sequential sample was used to select 40 patients with diagnosed Heart Failure II-IV FC (NYHA), who were then randomized into two groups: the follow-up group (n = 20) and the control group (n = 20). The study duration was 8 weeks. Patients of the observation group received materials on self-control (“Diary of a patient with heart failure”). For them, 3 control visits and 8 phone calls were organized once a week. The participants of the control group were observed in the usual conditions of practical health care; 3 control visits to the doctor were provided for them....
Russian Family Doctor
Objectives. This paper sought to provide normative values for grip strength among older adults 65... more Objectives. This paper sought to provide normative values for grip strength among older adults 65+ across different age groups in northwest Russia. Methods. A population-based prospective cohort study of 611 community-dwelling individuals 65+. Grip strength was measured using the standard protocol applied in the Groningen Elderly Tests. The cut-off thresholds for grip strength were defined separately for men and women of different ages using a weighted polynomial regression. Results and conclusions. 1. This study presents age- and sex-specific reference values for grip strength in the 65+ Russian population derived from a prospective cohort study. 2. The grip strength values obtained in the current study were lower than those reported in other population-based studies in Europe and USA.
Russian Family Doctor
The lecture presents modern concepts of diagnosis and treatment of atrial fibrillation; principle... more The lecture presents modern concepts of diagnosis and treatment of atrial fibrillation; principles of choosing the tactics of management of atrial fibrillation in general practice. The epidemiology of atrial fibrillation, risk factors, causes and mechanisms of its development are considered. The classification of atrial fibrillation is given. The tactic of diagnosis of atrial fibrillation is described. The principles of treatment of atrial fibrillation, including the anticoagulant therapy and pharmacological cardioversion, are presented.
Aging Clinical and Experimental Research, 2016
The classical phenotype, accumulated deficit model and self-report approach of frailty were found... more The classical phenotype, accumulated deficit model and self-report approach of frailty were found not useful in older adults in northwest Russia. More research is needed to identify predictors of adverse outcomes in this population. The aim of this study is to identify predictors of mortality, autonomy and cognitive decline in a population that is characterized by a high cardiovascular morbidity and mortality rate. A population-based prospective cohort study of 611 community-dwelling individuals 65+. Anthropometry, medical history nutritional status were recorded. An evaluation of cognitive, physical and autonomy function, spirometry, and laboratory tests were performed. The total follow-up was 5 years. Multiple imputation, backward stepwise Cox regression analysis, C-statistic, risk reclassification analysis and the bootstrapping techniques were used to analyze the data. We found that the combination of increasing age, male sex, low physical function, low mid-arm muscle area, low forced expiratory volume in 1 s and anemia was associated with mortality for people 65+. The substitution of anemia with anemia + high level of C-reactive protein (hCRP) and the addition of high brain natriuretic peptide (hBNP) levels improved the classification of older persons at risk for mortality. The combination of low physical function, low mid-arm muscle area, low forced expiratory volume in 1 s, anemia with hCRP levels and hBNP identified older persons at a higher risk for mortality. These predictors may be used for the development of a prediction model to detect older people who are at risk for adverse health outcomes in northwest Russia.
Journal of the American Geriatrics Society, 2011
To categorize the health problems of older Russians and identify the number of frail older adults... more To categorize the health problems of older Russians and identify the number of frail older adults using different approaches. Cross-sectional study. The Kolpino district of St. Petersburg. A random sample of 611 community-dwelling adults aged 65 and older was selected from a population-based register and stratified into two age groups (65-74, ≥75). Anthropometry, medical history, nutritional status, Physical Performance Battery, activities of daily living, grip strength, spirometry, renal function, 15-item Geriatric Depression Scale, Mini-Mental State Examination, and sense of coherence. The female:male ratio was 2.5:1; 19% were malnourished or at risk for malnutrition, and 78.6% presented with one to three chronic pathologies, with no differences according to age or sex. Problems with hearing (60.7%), vision (89.5%), and incontinence (40.9%) were highly prevalent. Moreover, 25.9% of the younger group (65-74) and 42.5% of the older group (≥75) were found to be at risk for depression. Mild to severe cognitive impairment was found in 34.5% of the participants, and 14.4% of those aged 65 to 74 and 33.0% of those aged 75 and older reported dependence in daily living activities. The prevalence of frailty assessed using different models varied from 21.1% to 43.9%. The Fried model revealed the strongest associations with the frailty outcomes (dependence and performance). No significant differences between the sexes were found in either age group (P=.82), although the percentage of frail women increased with age (P=.001). The findings emphasize the need for attention and resources to be shifted from disease-oriented to functional approaches in the older Russian population. The population studied is consistent with the Fried model, in which one in five older adults can be labeled as frail.
Journal of the American Geriatrics Society, 2011
To categorize the health problems of older Russians and identify the number of frail older adults... more To categorize the health problems of older Russians and identify the number of frail older adults using different approaches. Cross-sectional study. The Kolpino district of St. Petersburg. A random sample of 611 community-dwelling adults aged 65 and older was selected from a population-based register and stratified into two age groups (65-74, ≥75). Anthropometry, medical history, nutritional status, Physical Performance Battery, activities of daily living, grip strength, spirometry, renal function, 15-item Geriatric Depression Scale, Mini-Mental State Examination, and sense of coherence. The female:male ratio was 2.5:1; 19% were malnourished or at risk for malnutrition, and 78.6% presented with one to three chronic pathologies, with no differences according to age or sex. Problems with hearing (60.7%), vision (89.5%), and incontinence (40.9%) were highly prevalent. Moreover, 25.9% of the younger group (65-74) and 42.5% of the older group (≥75) were found to be at risk for depression. Mild to severe cognitive impairment was found in 34.5% of the participants, and 14.4% of those aged 65 to 74 and 33.0% of those aged 75 and older reported dependence in daily living activities. The prevalence of frailty assessed using different models varied from 21.1% to 43.9%. The Fried model revealed the strongest associations with the frailty outcomes (dependence and performance). No significant differences between the sexes were found in either age group (P=.82), although the percentage of frail women increased with age (P=.001). The findings emphasize the need for attention and resources to be shifted from disease-oriented to functional approaches in the older Russian population. The population studied is consistent with the Fried model, in which one in five older adults can be labeled as frail.
BMC medicine, Jan 22, 2016
The Short Physical Performance Battery (SPPB) is a well-established tool to assess lower extremit... more The Short Physical Performance Battery (SPPB) is a well-established tool to assess lower extremity physical performance status. Its predictive ability for all-cause mortality has been sparsely reported, but with conflicting results in different subsets of participants. The aim of this study was to perform a meta-analysis investigating the relationship between SPPB score and all-cause mortality. Articles were searched in MEDLINE, the Cochrane Library, Google Scholar, and BioMed Central between July and September 2015 and updated in January 2016. Inclusion criteria were observational studies; >50 participants; stratification of population according to SPPB value; data on all-cause mortality; English language publications. Twenty-four articles were selected from available evidence. Data of interest (i.e., clinical characteristics, information after stratification of the sample into four SPPB groups [0-3, 4-6, 7-9, 10-12]) were retrieved from the articles and/or obtained by the study...
Archives of Gerontology and Geriatrics, 2014
The health-care and social-security programs of industrialized countries across the world are con... more The health-care and social-security programs of industrialized countries across the world are confronted with the problem of aging populations. In 2010, people over the age of 65 accounted for 16% of the total population of the European Union, and this proportion is projected to rise to 28% by 2050 (Population projections, http://epp.eurostat.ec.europa.eu). Similarly, in 2010, 40.2 million people in the United States of America (13% of the population) were over the age of 65, and this number is projected to rise to 88.5 million (20% of the population) by 2050 (Projected future growth, http://www.aoa.gov). Unavoidably, this so-called 'gray epidemic' will lead to higher burdens of chronic disease, functional decline and disability for these industrialized nations. Russia is currently facing an important demographic transition. Over the next 15 years, the population will continue to age and is expected to shrink by 12% due to high mortality and a low birth rate (Anos-Casero, Ulatov, & Emelyanova, 2007). In particular, the cardiovascular disease (CVD) death rate in Russia, which mainly affects middle-aged men, is among the world's highest (829 per 100,000 people) (Population by age groups, http:// www.gks.ru.2010). However, these demographic changes have also resulted in a growing population of CVD survivors. Considering that the proportion of people over the age of 65 in Russia is projected to rise from 14% in 2005 to 26% by 2050 (Pirozhkov, Safarova, & Shcherbov, 2007), the high burden of CVD in this population is of great concern. The Crystal study showed that 85% of people aged 65-74 had at least one cardiovascular (CV) morbidity and that 50% had two or more; for people over the age of 75, these numbers rose to 89% and 54%, respectively (Gurina, Frolova, & Degryse, 2011). The 'cardiovascular continuum' created by Braunwald and Dzau describes the progression from risk factors to asymptomatic cardiac dysfunction and eventually to symptomatic heart failure
International Psychogeriatrics, 2012
Depression is a common and treatable illness in late-life. However, many do not seek treatment an... more Depression is a common and treatable illness in late-life. However, many do not seek treatment and may suffer from the stigma of the illness, which may vary across cultures. The aim of this study was to compare attitudes about depression in primary care practices in South Korea, Russia, and the USA. A cross-sectional study was undertaken using a self-administered questionnaire and PHQ-9 diagnostic survey with 1,094 patients aged 60-93 years who attended a primary care clinic in Korea, Russia, or the USA. The mean age of participants was 71 years, with 61% being female. US patients were older and had higher education levels. Russian participants were more likely to be widowed and had lower self-rated health. The majority of participants agreed that depression is a kind of disease (Korea 77%, Russia 61%, USA 79%). Only 6% of US patients believed depression means a person is weak, compared to 78% (Korea) and 61% (Russia). Fewer US patients endorsed depression as a normal part of aging (29% vs. Korea at 42% and Russia at 54%). Among participants in the USA, age correlated negatively with endorsement of a medical model of depression (p = <0.001). Though there was wide variation between countries in attitudes about depression, the majority of each endorsed items reflected a medical model of depression. Korean and Russian participants endorsed the view of depression as a personal weakness more than participants in the USA. Demographic correlates of negative attitudes about depression were moderate to weak.
Advances in gerontology = Uspekhi gerontologii / Rossiĭskai͡a akademii͡a nauk, Gerontologicheskoe obshchestvo, 2011
Chronic kidney disease (CKD) has a high prevalence in the elderly. It has been recognized as an i... more Chronic kidney disease (CKD) has a high prevalence in the elderly. It has been recognized as an independent cardiovascular risk factor and detecting CKD is also important to ensure the appropriate dose of medication and to prevent further damage by limiting the use of potential harmful drugs. The aim of the research was to study the prevalence of CKD in elderly (> or = 65 years) in a St. Petersburg district and to study the impact of using different methods to estimate the GFR on the prevalence of different stages of CKD. The cross-sectional analysis of prospective population based study in the district of Kolpino was conducted. All creatinine measurements were performed in the same laboratory. Renal function was assessed calculating the eGFR using different creatinine based formulas. 611 elderly (65-91 years) were examined. Using the MDRD formula a prevalence of CKD stage III-V for males of 11% was found in stratum 1 and of 15% in stratum 2 and for females prevalence was 14 and ...
Advances in Gerontology, 2011
Using the "Crystal" study as an example of an epidemiological study that invest... more Using the "Crystal" study as an example of an epidemiological study that investigates global health of the elderly, the potential of a comprehensive geriatric assessment in primary care is illustrated. The results of the first cross-sectional data collection are presented in this paper with emphasis on the global health picture of the elderly; the average age was 75.08 +/- 5.96 years. In our study population one out of four participants was a male. Elderly mostly have a normal nutritional status with an average BMI of 28.6 +/- 4.94 kg/m2. On average, each participant has 2 +/- 1.27 pathologies, often cardiovascular. One out of four presents anemia. One third has symptoms of depression. In 44.4% of the patients a mild cognitive impairment was revealed. A more severe cognitive deficit was found in 26.2% of elderly. Every other old person has difficulties to keep balance in supine position for more than 10 seconds. One out of four elderly is partially dependent in their daily activity. Comprehensive geriatric assessment has the potential to identify priority issues in elderly health care and to inspire a management strategy. Further research is needed to create a simple instruments and an effective model to identify real health care needs of the elderly and to improve the quality of care and the successful collaboration between geriatricians and general practitioners.
European Geriatric Medicine, 2012
Archives of Gerontology and Geriatrics, 2014
Russian Family Doctor
The article analyzes the features of teaching geriatrics in the modern world on the example of th... more The article analyzes the features of teaching geriatrics in the modern world on the example of the educational project “Annual Spring School of Practical Geriatrics”, proves the need to use innovative techniques for effective and rapid training of geriatrics, in accordance with the needs of society and official government documents.
Russian Family Doctor
In this review the information is presented about new clinical guidelines on arterial hypertensio... more In this review the information is presented about new clinical guidelines on arterial hypertension, syncope guidelines, about screening of atrial fibrillation and antithrombotic and anticoagulants usage according clinical trials data. Attention is payed to digital technologies in health care sector. This information is based on data of European Cardiology Congress 2018.
Russian Family Doctor
The article presents the results of modern research regarding the mechanisms of the positive effe... more The article presents the results of modern research regarding the mechanisms of the positive effect of physical activity on cognitive functions, the benefits of aerobic exercise, and recommendations on physical activity for older adults with cognitive impairment.
Russian Family Doctor
Atrial fibrillation (AF) is the most common rhythm disorder. The consequences of undiagnosed AF a... more Atrial fibrillation (AF) is the most common rhythm disorder. The consequences of undiagnosed AF are an increased risk of developing of heart failure and thromboembolic complications. The article is devoted to study of the possibility of using the medical device MyDiagnostick 1001R® in clinical practice for patients with the risk of AF development for early stage diagnosis. Methods. A group of subjects included 30 patients who did not have a history of AF, but who had the risk factors for its development — arterial hypertension, diabetes, obesity, ischemic heart disease (IHD). The average age of participants was 65.9 ± 12.1 years. A questionnaire containing 16 questions was developed to identify the risk factors of AF development. Results. From 30 participants 80% had arterial hypertension, 43.3% diabetes, 3.3% were obese, 50% suffered from IHD, 16.6% had stroke in anamnesis and 23.3% were smokers. All patients had a combination of risk factors. As a result, with the help of MyDiagno...
Russian Family Doctor
Due to the low detectability of atrial fibrillation (AF), more attention is paid to AF screening.... more Due to the low detectability of atrial fibrillation (AF), more attention is paid to AF screening. Screening procedure requires new diagnostic devices that allow immediate assessment of heart activity. One such portable device is the MyDyagnostick 1001R. The aim. Сomparison of the clinical effectiveness of screening in people who participated in the preventive health examinations and in patients with AF risk factors admitted to the City geriatric medical hospital. Materials and methods. 101 patients hospitalized to City geriatric medical center were included using the method of continuous selection. Another sample of patients included 102 volunteers who participated in a preventive health examinations organized by the City center for medical prevention in St. Petersburg (convenience sample). Heart activity was registered with portable device MyDyagnostick 1001R. Results. AF was diagnosed in 25 (24.8%) patients from geriatric medical center were. Of these, 12 patients were not suspect...
Russian Family Doctor
Анализируя научную и образовательную деятельность кафедры семейной медицины СЗГМУ им. И.И. Мечник... more Анализируя научную и образовательную деятельность кафедры семейной медицины СЗГМУ им. И.И. Мечникова, автор обосновывает необходимость нового подхода к обучению гериатрии, базируясь на опыте научных исследований, проведенных и продолжающихся на кафедре. Ключевые слова: общая врачебная практика, научная деятельность, гериатрия, обучение, инновационное обучение. On the basis of analysis of scientific activity of department of family medicine the author discusses the need of new educational technologies, especially in geriatrics. As an example of research based education new educational activities used the results of the Crystal study are described.
Russian Family Doctor
The results of investigation of sample of 107 patients 60 years and older during one month are de... more The results of investigation of sample of 107 patients 60 years and older during one month are described. This sample was collected in geriatric outpatient departments. The prevalence of geriatric syndromes was assessed. The main geriatric syndromes revealed were high risk of falls, risk of malnutrition, depression and cognitive disorders. 67% of patients were frail. All geriatric syndromes caused high level of dependency. The geriatrician made recommendations for correction of main problems. All recommendations need to use multidisciplinary approach.
Russian Family Doctor
Chronic heart failure (CHF) is the most frequent and severe complication of cardiovascular diseas... more Chronic heart failure (CHF) is the most frequent and severe complication of cardiovascular disease (CVD). One of the most important aspects of management of patients with CHF remains to ensure adherence to treatment. The purpose of the study was to assess the effectiveness of therapy of patients with CHF with the use of a diary of self-control as a way of enhancing adherence to therapy. Materials and methods. A continuous sequential sample was used to select 40 patients with diagnosed Heart Failure II-IV FC (NYHA), who were then randomized into two groups: the follow-up group (n = 20) and the control group (n = 20). The study duration was 8 weeks. Patients of the observation group received materials on self-control (“Diary of a patient with heart failure”). For them, 3 control visits and 8 phone calls were organized once a week. The participants of the control group were observed in the usual conditions of practical health care; 3 control visits to the doctor were provided for them....
Russian Family Doctor
Objectives. This paper sought to provide normative values for grip strength among older adults 65... more Objectives. This paper sought to provide normative values for grip strength among older adults 65+ across different age groups in northwest Russia. Methods. A population-based prospective cohort study of 611 community-dwelling individuals 65+. Grip strength was measured using the standard protocol applied in the Groningen Elderly Tests. The cut-off thresholds for grip strength were defined separately for men and women of different ages using a weighted polynomial regression. Results and conclusions. 1. This study presents age- and sex-specific reference values for grip strength in the 65+ Russian population derived from a prospective cohort study. 2. The grip strength values obtained in the current study were lower than those reported in other population-based studies in Europe and USA.
Russian Family Doctor
The lecture presents modern concepts of diagnosis and treatment of atrial fibrillation; principle... more The lecture presents modern concepts of diagnosis and treatment of atrial fibrillation; principles of choosing the tactics of management of atrial fibrillation in general practice. The epidemiology of atrial fibrillation, risk factors, causes and mechanisms of its development are considered. The classification of atrial fibrillation is given. The tactic of diagnosis of atrial fibrillation is described. The principles of treatment of atrial fibrillation, including the anticoagulant therapy and pharmacological cardioversion, are presented.
Aging Clinical and Experimental Research, 2016
The classical phenotype, accumulated deficit model and self-report approach of frailty were found... more The classical phenotype, accumulated deficit model and self-report approach of frailty were found not useful in older adults in northwest Russia. More research is needed to identify predictors of adverse outcomes in this population. The aim of this study is to identify predictors of mortality, autonomy and cognitive decline in a population that is characterized by a high cardiovascular morbidity and mortality rate. A population-based prospective cohort study of 611 community-dwelling individuals 65+. Anthropometry, medical history nutritional status were recorded. An evaluation of cognitive, physical and autonomy function, spirometry, and laboratory tests were performed. The total follow-up was 5 years. Multiple imputation, backward stepwise Cox regression analysis, C-statistic, risk reclassification analysis and the bootstrapping techniques were used to analyze the data. We found that the combination of increasing age, male sex, low physical function, low mid-arm muscle area, low forced expiratory volume in 1 s and anemia was associated with mortality for people 65+. The substitution of anemia with anemia + high level of C-reactive protein (hCRP) and the addition of high brain natriuretic peptide (hBNP) levels improved the classification of older persons at risk for mortality. The combination of low physical function, low mid-arm muscle area, low forced expiratory volume in 1 s, anemia with hCRP levels and hBNP identified older persons at a higher risk for mortality. These predictors may be used for the development of a prediction model to detect older people who are at risk for adverse health outcomes in northwest Russia.
Journal of the American Geriatrics Society, 2011
To categorize the health problems of older Russians and identify the number of frail older adults... more To categorize the health problems of older Russians and identify the number of frail older adults using different approaches. Cross-sectional study. The Kolpino district of St. Petersburg. A random sample of 611 community-dwelling adults aged 65 and older was selected from a population-based register and stratified into two age groups (65-74, ≥75). Anthropometry, medical history, nutritional status, Physical Performance Battery, activities of daily living, grip strength, spirometry, renal function, 15-item Geriatric Depression Scale, Mini-Mental State Examination, and sense of coherence. The female:male ratio was 2.5:1; 19% were malnourished or at risk for malnutrition, and 78.6% presented with one to three chronic pathologies, with no differences according to age or sex. Problems with hearing (60.7%), vision (89.5%), and incontinence (40.9%) were highly prevalent. Moreover, 25.9% of the younger group (65-74) and 42.5% of the older group (≥75) were found to be at risk for depression. Mild to severe cognitive impairment was found in 34.5% of the participants, and 14.4% of those aged 65 to 74 and 33.0% of those aged 75 and older reported dependence in daily living activities. The prevalence of frailty assessed using different models varied from 21.1% to 43.9%. The Fried model revealed the strongest associations with the frailty outcomes (dependence and performance). No significant differences between the sexes were found in either age group (P=.82), although the percentage of frail women increased with age (P=.001). The findings emphasize the need for attention and resources to be shifted from disease-oriented to functional approaches in the older Russian population. The population studied is consistent with the Fried model, in which one in five older adults can be labeled as frail.
Journal of the American Geriatrics Society, 2011
To categorize the health problems of older Russians and identify the number of frail older adults... more To categorize the health problems of older Russians and identify the number of frail older adults using different approaches. Cross-sectional study. The Kolpino district of St. Petersburg. A random sample of 611 community-dwelling adults aged 65 and older was selected from a population-based register and stratified into two age groups (65-74, ≥75). Anthropometry, medical history, nutritional status, Physical Performance Battery, activities of daily living, grip strength, spirometry, renal function, 15-item Geriatric Depression Scale, Mini-Mental State Examination, and sense of coherence. The female:male ratio was 2.5:1; 19% were malnourished or at risk for malnutrition, and 78.6% presented with one to three chronic pathologies, with no differences according to age or sex. Problems with hearing (60.7%), vision (89.5%), and incontinence (40.9%) were highly prevalent. Moreover, 25.9% of the younger group (65-74) and 42.5% of the older group (≥75) were found to be at risk for depression. Mild to severe cognitive impairment was found in 34.5% of the participants, and 14.4% of those aged 65 to 74 and 33.0% of those aged 75 and older reported dependence in daily living activities. The prevalence of frailty assessed using different models varied from 21.1% to 43.9%. The Fried model revealed the strongest associations with the frailty outcomes (dependence and performance). No significant differences between the sexes were found in either age group (P=.82), although the percentage of frail women increased with age (P=.001). The findings emphasize the need for attention and resources to be shifted from disease-oriented to functional approaches in the older Russian population. The population studied is consistent with the Fried model, in which one in five older adults can be labeled as frail.
BMC medicine, Jan 22, 2016
The Short Physical Performance Battery (SPPB) is a well-established tool to assess lower extremit... more The Short Physical Performance Battery (SPPB) is a well-established tool to assess lower extremity physical performance status. Its predictive ability for all-cause mortality has been sparsely reported, but with conflicting results in different subsets of participants. The aim of this study was to perform a meta-analysis investigating the relationship between SPPB score and all-cause mortality. Articles were searched in MEDLINE, the Cochrane Library, Google Scholar, and BioMed Central between July and September 2015 and updated in January 2016. Inclusion criteria were observational studies; >50 participants; stratification of population according to SPPB value; data on all-cause mortality; English language publications. Twenty-four articles were selected from available evidence. Data of interest (i.e., clinical characteristics, information after stratification of the sample into four SPPB groups [0-3, 4-6, 7-9, 10-12]) were retrieved from the articles and/or obtained by the study...
Archives of Gerontology and Geriatrics, 2014
The health-care and social-security programs of industrialized countries across the world are con... more The health-care and social-security programs of industrialized countries across the world are confronted with the problem of aging populations. In 2010, people over the age of 65 accounted for 16% of the total population of the European Union, and this proportion is projected to rise to 28% by 2050 (Population projections, http://epp.eurostat.ec.europa.eu). Similarly, in 2010, 40.2 million people in the United States of America (13% of the population) were over the age of 65, and this number is projected to rise to 88.5 million (20% of the population) by 2050 (Projected future growth, http://www.aoa.gov). Unavoidably, this so-called 'gray epidemic' will lead to higher burdens of chronic disease, functional decline and disability for these industrialized nations. Russia is currently facing an important demographic transition. Over the next 15 years, the population will continue to age and is expected to shrink by 12% due to high mortality and a low birth rate (Anos-Casero, Ulatov, & Emelyanova, 2007). In particular, the cardiovascular disease (CVD) death rate in Russia, which mainly affects middle-aged men, is among the world's highest (829 per 100,000 people) (Population by age groups, http:// www.gks.ru.2010). However, these demographic changes have also resulted in a growing population of CVD survivors. Considering that the proportion of people over the age of 65 in Russia is projected to rise from 14% in 2005 to 26% by 2050 (Pirozhkov, Safarova, & Shcherbov, 2007), the high burden of CVD in this population is of great concern. The Crystal study showed that 85% of people aged 65-74 had at least one cardiovascular (CV) morbidity and that 50% had two or more; for people over the age of 75, these numbers rose to 89% and 54%, respectively (Gurina, Frolova, & Degryse, 2011). The 'cardiovascular continuum' created by Braunwald and Dzau describes the progression from risk factors to asymptomatic cardiac dysfunction and eventually to symptomatic heart failure
International Psychogeriatrics, 2012
Depression is a common and treatable illness in late-life. However, many do not seek treatment an... more Depression is a common and treatable illness in late-life. However, many do not seek treatment and may suffer from the stigma of the illness, which may vary across cultures. The aim of this study was to compare attitudes about depression in primary care practices in South Korea, Russia, and the USA. A cross-sectional study was undertaken using a self-administered questionnaire and PHQ-9 diagnostic survey with 1,094 patients aged 60-93 years who attended a primary care clinic in Korea, Russia, or the USA. The mean age of participants was 71 years, with 61% being female. US patients were older and had higher education levels. Russian participants were more likely to be widowed and had lower self-rated health. The majority of participants agreed that depression is a kind of disease (Korea 77%, Russia 61%, USA 79%). Only 6% of US patients believed depression means a person is weak, compared to 78% (Korea) and 61% (Russia). Fewer US patients endorsed depression as a normal part of aging (29% vs. Korea at 42% and Russia at 54%). Among participants in the USA, age correlated negatively with endorsement of a medical model of depression (p = <0.001). Though there was wide variation between countries in attitudes about depression, the majority of each endorsed items reflected a medical model of depression. Korean and Russian participants endorsed the view of depression as a personal weakness more than participants in the USA. Demographic correlates of negative attitudes about depression were moderate to weak.
Advances in gerontology = Uspekhi gerontologii / Rossiĭskai͡a akademii͡a nauk, Gerontologicheskoe obshchestvo, 2011
Chronic kidney disease (CKD) has a high prevalence in the elderly. It has been recognized as an i... more Chronic kidney disease (CKD) has a high prevalence in the elderly. It has been recognized as an independent cardiovascular risk factor and detecting CKD is also important to ensure the appropriate dose of medication and to prevent further damage by limiting the use of potential harmful drugs. The aim of the research was to study the prevalence of CKD in elderly (> or = 65 years) in a St. Petersburg district and to study the impact of using different methods to estimate the GFR on the prevalence of different stages of CKD. The cross-sectional analysis of prospective population based study in the district of Kolpino was conducted. All creatinine measurements were performed in the same laboratory. Renal function was assessed calculating the eGFR using different creatinine based formulas. 611 elderly (65-91 years) were examined. Using the MDRD formula a prevalence of CKD stage III-V for males of 11% was found in stratum 1 and of 15% in stratum 2 and for females prevalence was 14 and ...
Advances in Gerontology, 2011
Using the "Crystal" study as an example of an epidemiological study that invest... more Using the "Crystal" study as an example of an epidemiological study that investigates global health of the elderly, the potential of a comprehensive geriatric assessment in primary care is illustrated. The results of the first cross-sectional data collection are presented in this paper with emphasis on the global health picture of the elderly; the average age was 75.08 +/- 5.96 years. In our study population one out of four participants was a male. Elderly mostly have a normal nutritional status with an average BMI of 28.6 +/- 4.94 kg/m2. On average, each participant has 2 +/- 1.27 pathologies, often cardiovascular. One out of four presents anemia. One third has symptoms of depression. In 44.4% of the patients a mild cognitive impairment was revealed. A more severe cognitive deficit was found in 26.2% of elderly. Every other old person has difficulties to keep balance in supine position for more than 10 seconds. One out of four elderly is partially dependent in their daily activity. Comprehensive geriatric assessment has the potential to identify priority issues in elderly health care and to inspire a management strategy. Further research is needed to create a simple instruments and an effective model to identify real health care needs of the elderly and to improve the quality of care and the successful collaboration between geriatricians and general practitioners.
European Geriatric Medicine, 2012
Archives of Gerontology and Geriatrics, 2014