problendoПроблемы ЭндокринологииProblems of Endocrinology0375-96602308-1430Endocrinology Research Centre10.14341/probl12751problendo-12751Research ArticleБолезни костной и жировой тканиBones & Adipose tissues diseasesХарактеристика гериатрического и соматического статуса у пациентов с остеопорозомCharacteristics of geriatric and somatic status in patients with osteoporosishttps://orcid.org/0000-0002-3066-4866ХовасоваН. О.KhovasovaN. O.

Ховасова Наталья Олеговна - кандидат медицинских наук, доцент кафедры болезней старения РНИМУ им. Пирогова, старший научный сотрудник лаборатории заболеваний костной-мышечной системы РГНКЦ.

Москва, ул. 1-я Леонова, д. 16.

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Natalia O. Khovasova - PhD, associate Professor.

Moscow, First Leonova str., 16.

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natashahov@mail.ruhttps://orcid.org/0000-0002-6253-621XНаумовА. В.NaumovA. V.

Наумов Антон Вячеславович - доктор медицинских наук, доцент.

Москва, ул. 1-я Леонова, д. 16.

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Anton V. Naumov – PhD.

Moscow, First Leonova str., 16.

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nanton78@gmail.comhttps://orcid.org/0000-0002-4193-688XТкачеваО. Н.TkachevaO. N.

Ткачева Ольга Николаевна - доктор медицинских наук, профессор.

Москва, ул. 1-я Леонова, д. 16.

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Olga N. Tkacheva – PhD.

Moscow, First Leonova str., 16.

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ton@rgnkc.ruhttps://orcid.org/0000-0001-7891-6850ДудинскаяЕ. Н.DudinskayaE. N.

Дудинская Екатерина Наильевна - кандидат медицинских наук.

Москва, ул. 1-я Леонова, д. 16.

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Ekaterina N. Dudinskaya – PhD.

Moscow, First Leonova str., 16.

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katharina.gin@gmail.comКафедра болезней старения Российского национального исследовательского медицинского университета им. Н.И. Пирогова; Российский геронтологический научно-клинический центрРоссияDepartment of diseases of aging of The Pirogov Russian National Research Medical University; Russian Gerontology Clinical ResearchRussian Federation2021170620216734554Copyright © Ховасова Н.О., Наумов А.В., Ткачева О.Н., Дудинская Е.Н., 20212021Ховасова Н.О., Наумов А.В., Ткачева О.Н., Дудинская Е.Н.Khovasova N.O., Naumov A.V., Tkacheva O.N., Dudinskaya E.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.probl-endojournals.ru/jour/article/view/12751ОБОСНОВАНИЕ

ОБОСНОВАНИЕ. Пожилые люди с остеопорозом (ОП) и высоким риском падений — наиболее уязвимая группа пациентов в отношении развития переломов. Падения и переломы у пожилых пациентов с ОП ассоциированы с гериатрическими синдромами и худшим функциональным статусом.

ЦЕЛЬ

ЦЕЛЬ. Оценить коморбидный и гериатрический статус пациентов пожилого и старческого возраста с ОП и без него.

МАТЕРИАЛЫ И МЕТОДЫ

МАТЕРИАЛЫ И МЕТОДЫ. В исследование включены 607 пациентов старше 60 лет, госпитализированных в гериатрическое отделение. По наличию ОП пациенты были разделены на 2 группы: 1 группа — пациенты с ОП (n=178, 29,3%), 2 группа — пациенты без ОП (n=429, 70,7%). Всем пациентам проводились общеклиническое исследование, оценка коморбидности по индексу Чарльсон, комплексная гериатрическая оценка.

РЕЗУЛЬТАТЫ

РЕЗУЛЬТАТЫ. ОП имели 178 (29,3%) пациентов, чаще это были женщины. 55,6% пациентов с ОП были инвалидами. У пациентов с ОП достоверно чаще встречались возраст-ассоциированные заболевания — болезнь Альцгеймера, болезнь Паркинсона, остеоартрит, анемия, заболевания щитовидной железы, варикозная болезнь. Практически со всеми этими заболеваниями при однофакторном анализе выявлена ассоциация с ОП. У пациентов 1 группы достоверно чаще встречались такие гериатрические синдромы, как старческая астения, гиподинамия, недостаточность питания, полипрагмазия, недержание мочи. Пациенты с ОП чаще проживали одиноко и использовали вспомогательные средства при передвижении в сравнении с пациентами без ОП. Проведенный однофакторный анализ продемонстрировал, что ОП ассоциирован (отношение шансов (ОШ) 1,54–2,00) со старческой астенией, гиподинамией, использованием вспомогательных средств при передвижении, нарушением сна, сенсорным дефицитом по зрению, недержанием мочи. Функциональный статус пациентов с ОП был хуже по сравнению с пациентами без ОП. Пациенты с ОП перенесли больше переломов.

ЗАКЛЮЧЕНИЕ

ЗАКЛЮЧЕНИЕ. Пациенты с ОП имеют высокую коморбидность, отягощенный гериатрический статус. У пациентов пожилого и старческого возраста необходимо не только проводить скрининг и диагностику ОП, оценивать риск 10-летней вероятности основных патологических переломов по алгоритму FRAX, но и проводить комплексную гериатрическую оценку для диагностики гериатрических синдромов, которые утяжеляют течение ОП и приводят к более серьезным последствиям.

BACKGROUND

BACKGROUND: Older adults with osteoporosis (OP) and high risk of falls are the most vulnerable group of patients with respect to the development of fractures. Falls and fractures in elderly patients with OP are associated with geriatric syndromes and worse functional status.

AIM

AIM: To аssess comorbidity and geriatric status in elderly and senile patients with and without OP.

MATERIALS AND METHODS

MATERIALS AND METHODS: The study included 607 patients over 60 years of age hospitalized in the geriatric department. According to the presence of OP, the patients were divided into 2 groups: group 1 — patients with OP (n=178, 29.3%), group 2 — patients without OP (n=429, 70.7%). All patients underwent a general clinical study, an assessment of comorbidity ­according to the Charlson index, and a comprehensive geriatric score.

RESULTS

RESULTS: OPs had 178 (29.3%) patients, more often these were women. 55.6% of patients with OP were disabled. Age-­related diseases such as Alzheimer’s disease, Parkinson’s disease, osteoarthritis, anemia, thyroid disease, varicose veins were significantly more common in patients with OP. With almost all of these diseases, a univariate analysis revealed an association with OP. Geriatric syndromes such as frailty, hypodynamia, malnutrition, polypharmacy, urinary incontinence were significantly more common in group 1 patients. Patients with OP were more likely to live alone and use mobility aids compared to patients without OP.

The univariate analysis demonstrated that OP is associated (OR 1.54 to 2.00) with frailty, hypodynamia, the use of aids in movement, sleep disorders, sensory vision deficiency, urinary incontinence. The Functional status of patients with OP was worse compared to patients without OP. Patients with OP suffered more fractures, and vertebral fractures were significantly more frequent.

CONCLUSION

CONCLUSION: Patients with OP have a high comorbidity, a burdened geriatric status. In elderly patients, it is necessary not only to screen and diagnose OP, to assess the risk of 10-years probability of major pathological fractures using the FRAX algorithm, but also to conduct a comprehensive geriatric assessment to diagnose geriatric syndromes that weaken the course of OP and lead to more serious consequences.

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The authors declare that there are no conflicts of interest present.