r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2025-30-1-4-15r-n-j-660Research ArticleОБЗОРЫREVIEWSПроблемы хрупкости в современной гериатрии и неврологииFrailty in modern geriatrics and neurologyhttps://orcid.org/0000-0001-5742-8356КомлеваЮ. К.KomlevaYu. K.

Москва

Moscow

yuliakomleva@mail.ruhttps://orcid.org/0000-0003-4012-6348СалминаА. Б.SalminaA. B.

Москва

Moscow

allasalmina@mail.ruhttps://orcid.org/0009-0005-1182-478XШпилюковаК. А.ShpiliukovaK. A.

Москва

Moscow

kristi14035@gmail.ruhttps://orcid.org/0009-0002-7008-7642БондарьН. И.BondarN. I.

Москва

Moscow

niko13bondar@gmail.comhttps://orcid.org/0000-0001-7214-583XШпилюковаЮ. А.ShpilyukovaYu. A.

Москва

Moscow

shpilyukova@neurology.ruhttps://orcid.org/0000-0002-2704-6282ИллариошкинС. Н.IllarioshkinS. N.

Москва

Moscow

snillario@gmail.comНаучный центр неврологииРоссияBrain Institute, Federal State Budgetary Scientific Institution “Scientific Center of Neurology”Russian FederationНаучный центр неврологии; Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский университет)РоссияBrain Institute, Federal State Budgetary Scientific Institution “Scientific Center of Neurology”; I.M. Sechenov First Moscow State Medical UniversityRussian Federation202510052025301415Copyright © Комлева Ю.К., Салмина А.Б., Шпилюкова К.А., Бондарь Н.И., Шпилюкова Ю.А., Иллариошкин С.Н., 20252025Комлева Ю.К., Салмина А.Б., Шпилюкова К.А., Бондарь Н.И., Шпилюкова Ю.А., Иллариошкин С.Н.Komleva Y.K., Salmina A.B., Shpiliukova K.A., Bondar N.I., Shpilyukova Y.A., Illarioshkin S.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.r-n-j.com/jour/article/view/660

Старение сопровождается значительным ростом числа возраст-ассоциированных заболеваний, что оказывает серьезное влияние как на конкретного человека, так и на общество в целом. На фоне неуклонного роста числа пожилых людей в медицине активно используется концепция хрупкости, что подразумевает повышенную уязвимость к различным проблемам со здоровьем, связанную с уменьшением физиологических резервов на фоне старения, в том числе и ускоренного старения при нейродегенерации. Психосоциальные, экологические и возрастные биологические факторы вносят свой вклад в снижение физических и когнитивных способностей. Кульминация их действия приводит к состоянию, известному как физическая хрупкость, в дополнение к которому все больше исследователей выделяют феномен когнитивной хрупкости как проявление когнитивных нарушений на фоне нарастающей физической слабости. В обзоре представлен актуальный анализ литературы о хрупкости как многомерном и динамическом процессе, с акцентом на роль когнитивного резерва в старении. Рассматриваются данные поперечных и продольных исследований, показывающих, что когнитивная хрупкость связана с повышенным риском инвалидизации, ухудшением качества жизни, госпитализаций, смертностью и нейрокогнитивными расстройствами. Это подчеркивает важность введения данного понятия в клиническую практику гериатров и неврологов. В статье рассмотрены данные об эпидемиологии, используемых диагностических подходах, а также перспективы будущих исследований.

Aging is accompanied by a significant increase in the number of age-associated diseases, which has a serious impact on the individual and society. Against the background of a steady increase in the number of elderly people, the concept of frailty is now actively used in medicine. It implies increased vulnerability to various health problems associated with a decrease in physiological reserves against the background of aging, including accelerated aging in neurodegeneration. Psychosocial, environmental and age-related biological factors contribute to the decline in physical and cognitive abilities. Their culmination leads to the condition known as physical frailty, in addition to which a lot of researchers are emphasizing the phenomenon of cognitive frailty as a manifestation of cognitive impairment on the background of increasing physical weakness. The review presents an up-to-date analysis of the literature on frailty as a multidimensional and dynamic process, focusing on the role of cognitive reserve in aging. Evidence from cross-sectional and longitudinal studies is reviewed, showing that cognitive frailty is associated with increased risk of disability, impaired quality of life, hospitalizations, mortality, and neurocognitive disorders. This emphasizes the importance of introducing this concept into the clinical practice of geriatricians and neurologists. The article reviews data on the epidemiology, diagnostic approaches used, and perspectives.

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