Senile asthenia syndrome (SAS) is a geriatric syndrome characterized by age-associated decline of the physiological reserve and function in multiple systems, which results in higher vulnerability to effects of endo- and exogenous factors and a high risk of unfavorable outcomes, loss of self-sufficiency, and death. Generally, SAS is observed in elderly patients with comorbidities. In cardiovascular diseases, SAS is associated with a poor prognosis, including a higher incidence of exacerbation and death both during acute events and in chronic disease. However, SAS is often not taken into account in developing diagnostic and therapeutic programs for managing elderly patients with cardiovascular diseases (CVD). This article analyzes available scientific information about SAS, algorithms for SAS diagnosis, and the scales that may be useful in developing individual plans for management of elderly patients with CVD.

A novel coronavirus infection SARS-CoV-2 (COVID19) is especially dangerous for elderly and senile patients. Preventive measures for elderly people should cover three areas: 1) direct prevention of the viral infection, 2) preservation of the functional status and prevention of geriatric syndromes, including the use of social support measures, 3) control of comorbidities. The clinical pattern of COVID-19 in older patients may be atypical, while the mildness of symptoms (no fever, cough, shortness of breath) may not correspond to the severity of the prognosis. Delirium may be the first manifestation of COVID-19, which requires special care in its screening. Management of elderly and senile patients with COVID19 should include measures for delirium prevention, the detection and improvement of nutrition. The risk of malnutrition with sarcopenia increases with hospitalization of a patient, especially when using artificial ventilation, is associated with an unfavorable prognosis during hospitalization, accelerates the progression of senile asthenia and reduces the quality of life. Geriatric assessment is the cornerstone of determining the management of an elderly patient.

The population of older and oldest-old individuals is increasing at a rapid pace, leading to a notable proportion of this age group requiring surgical procedures due to multimorbidity. It is known that, compared with young people, patients over 60 have a whole set of factors, such as decreased physiological functions, the presence of several concomitant diseases, polypharmacy, cognitive dysfunction and specific geriatric syndromes, which may lead to a higher risk of postoperative complications and prolonged recovery. Therefore, an integrated multidisciplinary approach on management is necessary for this group of patients, but the use of such an approach is currently rare. The purpose of this document is to review the literature, summarize current recommendations, and provide a set of expert recommendations to assist practicing geriatricians, surgeons, anesthetists, and allied health professionals.

Novel coronavirus SARS-CoV-2 infection (COVID-19) is a dangerous disease for older adults. Preventive measures in this population should involve three groups of measures: 1) prevention of infection; 2) prevention of functional decline and geriatric syndromes, including social support; 3) control of chronic comorbidity. Older adults are common to present with atypical COVID-19 symptoms, and mildness of symptoms (no fever, cough, shortness of breath) does not correspond to the severity of the prognosis. Delirium may be the first manifestation of COVID-19, that is why it is screening should be widely implied. Risk of malnutrition resulting in sarcopenia increases during the hospitalization, especially if mechanical ventilation required, and promotes frailty progression and decreases quality of life after the discharge from the hospital. Geriatric assessment is an important component of the decision making process in the management of older adults. Full version was published as Tkacheva O.N., Kotovskaya Yu.V., Aleksanyan L.A., Milto A.S., Naumov A.V., Strazhesko I.D., Vorobyeva N.M., Dudinskaya E.N., Malaya I.P., Krylov K.Yu., Tyukhmenev E.A., Rozanov A.V., Ostapenko V.S., Manevich T.M., Shchedrina A.Yu., Semenov F.A., Mkhitaryan E.A., Khovasova N.O., Yeruslanova E.A., Kotovskaya N.V., Sharashkina N.V. Novel coronavirus infection SARS-CoV-2 in elderly and senile patients: prevention, diagnosis and treatment. Expert Position Paper of the Russian Association of Gerontology and Geriatrics. Cardiovascular Therapy and Prevention. 2020; 19(3): 2601. DOI: 10.15829/1728-8800-2020-2601

An increasing senior population requires improvements in geriatric care. Elderly patients are prone to various age-related diseases combined with geriatric symptoms. In such cases, medical treatment involves collaboration between doctors of different specializations, nurses, social workers, and care professionals. To make such collaboration as efficient as possible, appropriate professional training and a regulatory framework for interaction, along with well-defined medical care algorithms, are necessary.