Atherosclerosis is a complex disease characterized by pathological thickening of the arterial intima. The mechanisms underlying the induction and progression of atherosclerosis are convoluted and remain under active investigation, with key components such as lipid accumulation and local inflammation being identified. Several risk factors (e.g., metabolic disorders, genetic background, diet, infections) have been shown to exacerbate disease progression, but their roles as clinically relevant markers remain to be established. Despite the growing body of evidence on the molecular pathogenesis of atherosclerosis, there is no effective preventive treatment against the development of this disease. In this review, we focus on gene targets for gene therapy as a novel potential approach to cure and prevent atherosclerosis. We critically review recent research demonstrating the therapeutic potential of viral vector-based (adeno-associated virus (AAV) and lentivirus) gene therapy for the treatment of atherosclerosis. We also summarize alternative gene targets and approaches (e.g., non-coding RNA (ncRNA), micro RNA (miRNA), small interfering RNA (siRNA), antisense oligonucleotide (ASO), CRISPR/Cas9) that aim to limit disease progression. We highlight the importance of local inflammation in the pathogenesis of atherosclerosis and propose gene targets with anti-inflammatory activity to inhibit the pathological inflammatory response. In addition, we provide perspectives on the future development of gene therapeutics and their potential applications. We anticipate that recent advances in gene therapy will help to identify new and effective targets to prevent atherosclerosis.

The article examines the relationship between social fragility and cognitive impairment (CI) in elderly in the context of population ageing and the increasing proportion of age-related diseases. Social fragility is defined as a progressive loss of social resources, including support and social engagement, which is associated with an increased risk of depression, cognitive decline and dementia.A comprehensive review of studies published between 2017, and November 2024 was conducted to examine social fragility and its association with CI. The paper provides an overview of current approaches to assessing social fragility, including the use of indices and scales. The main risk factors, including depression, physical activity and CI, and the mechanisms underlying this relationship are analyzed in detail.Particular attention is paid to the consequences of social fragility for cognitive health and possible prevention strategies. The article discusses the role of social isolation, loneliness, reduced physical activity and diminished social interactions as key aspects that increase the risk of cognitive decline. It also points out that maintaining an active social network and participating in social life can slow the progression of CI and improve the quality of life of elderly.Our work emphasizes the need for an interdisciplinary approach to the diagnosis and treatment of social fragility, which includes the development of social relationships, the promotion of physical activity and the participation in group activities. These measures can help to strengthen cognitive reserves, reduce the negative effects of social fragility and ensure an active, long life for the elderly population.

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.