Vol 27, No 2 (2024)

Background: The prevalence of sarcopenia and its impact on older adults undergoing inpatient cardiac rehabilitation after cardiac surgery are poorly understood.

Aim: To determine the level of sarcopenia and quantify the functional capacity of older patients with and without sarcopenia participating in a cardiac rehabilitation program.

Materials and methods: A sample of 122 patients over 75 years of age undergoing cardiac rehabilitation after cardiac surgery at the Voronezh Regional Clinical Hospital No. 1 was followed up for 3 months. The SARC-F questionnaire, which included questions on strength, assistance with mobility, getting up from a chair, climbing stairs, and falls, was used for the initial identification of patients with sarcopenia. The Katz index, Clinical Frailty Scale (CFS), Hand Grip Strength (HGS), Short Physical Performance Battery (SPPB), and 6-minute walking distance (6MWD) were also assessed to determine functional capacity and weakness at the initial stage. The primary outcomes were the prevalence of sarcopenia and its correlation with functional capacity and frailty at baseline, including the SARC-F score at follow-up. The Wilcoxon signed-rank test was used to compare before and after. Correlations between sarcopenia and 6MWD, SPPB and HGS were examined using the correlation coefficient and one-way analysis of variance.

Results: Complete data were collected from 101 patients (79.9±4.0 years; 63% men). At baseline, the mean SARC-F score was 2.7±2.1, with 35% of participants having sarcopenia. Other baseline parameters were: Kots index 5.7±0.9, CFS 3.2±1.4, HGS 24.9±9.9 kg, SPPB score 7.5±3.3, and 6MWD 288.8±136.5 m. Compared with baseline data, the proportion of patients with sarcopenia at follow-up decreased (23% vs. 35%). In the group of patients with sarcopenia at baseline (n=35), comparison of before and after data showed a statistically significant improvement in SARC-F (p=0.017). A significant correlation was also found between sarcopenia, as determined using SARC-F, and low functional assessment scores (p <0.001; r >0.546).

Conclusions: The incidence of sarcopenia in elderly patients in the interposition coronary resuscitation unit after cardiac surgery is quite high (35%) and remains high during follow-up (23%). Screening for sarcopenia is key, as its diagnosis in these patients is strongly associated with deterioration in functional performance. These studies indicate that these patients may benefit significantly from pre-planned rehabilitation aimed at improving postoperative outcomes, increasing functional activity, and reducing adverse effects.

BACKGROUND: The basic feature of the demographic situation in the Belgorod Oblast, as well as in the Russian Federation, is the continuing depopulation and reduction of the working age population. The results of the analysis of the demographic situation can be used as an information base for practical solutions to the prevention of morbidity, treatment and rehabilitation of patients in order to reduce premature mortality.

AIM: To analyze and assess the trends of the demographic situation in the Belgorod region in the period from 2010 to 2022.

MATERIALS AND METHODS: An observational retrospective continuous study of the demographic situation in the Belgorod region for 13 years (2010–2022) was carried out. Research methods: analytical, analytical-graphical, statistical, including descriptive statistics and time series analysis. Quantitative data were analyzed using absolute values, percentages, intensive indicators. Statistical significance of the studied indicators in dynamics, was assessed using F-criterion for the coefficients of determination (Student’s t-criterion for correlation coefficients with time variable) of linear trends of the corresponding time series.

RESULTS: In Belgorod region over the 12-year (2010–2022) period, the total population increased slightly by 0.4%; the observed total population growth was ensured until 2017 only by migration growth, and since 2018 it stopped compensating for the natural population decline (excess of the number of deaths over the number of births). In terms of the structure of the population, there was a significant increase in the proportion of the population above working age (growth rate +11.5%), while the proportion of the population of working age decreased (growth rate -7.8%). The demographic load per 1000 people of working age increased from 240 to 296 people for people younger than working age and from 382 to 461 people for people of retirement age. During the studied period negative dynamics of mortality rates from all causes in persons of working age, and in persons older than working age from diseases of digestive and respiratory organs was revealed.

CONCLUSION: In the period from 2010 to 2022, there are negative demographic trends characterised by depopulation due to a decline in birth rate, increased mortality and ageing of the population.

Injuries and disorders of the nervous system are a significant public health problem both in Russia and globally. In recent years, significant progress has been made in the development of spinal cord stimulation techniques aimed at restoring lost functions. Epidural (ESCS) and percutaneous (PSCS) spinal cord stimulation are promising approaches capable of improving motor activity and restoring sensitivity in patients with various neurological conditions. As a result of the research search, 3,887 publications were extracted from PubMed/MEDLINE databases and 1,432 publications found using Google Scholar. After the selection procedure, 66 articles were included in the review. Recent studies demonstrate that ESCS and PSCS can improve motor and sensory functions in various neurological diseases, opening up new opportunities to improve the quality of life of patients. Despite the fact that these neuromodulation methods have already proven their effectiveness in improving motor function and restoring sensory feedback, most of the work carried out so far has been in the nature of pilot studies. The successful clinical implementation of both ESCS and PSCS in the field of rehabilitation will require larger and more comprehensive studies, including home trials, to provide convincing evidence of their potential in restorative medicine. In addition, to optimize the effect on the dorsal roots of the spinal cord, it is necessary to improve existing electrode designs for ESCS. In this regard, further work and funding in the field of equipment development, stimulation protocols and scientific research for ESCS and PSCS should become priorities in the near future.