Проблемы хрупкости в современной гериатрии и неврологии

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.

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