rspНаучно-практическая ревматологияRheumatology Science and Practice1995-44841995-4492IMA-PRESS, LLC10.47360/1995-4484-2024-494-500rsp-3635Research ArticleФОРУМ МОЛОДЫХ УЧЕНЫХYOUNG SCIENTISTS FORUMРевматоидный артрит с дебютом в пожилом возрасте: от иммунного старения до организации специализированной помощиRheumatoid arthritis with onset in old age: From immune aging to the organization of specialized carehttps://orcid.org/0000-0003-3431-5580АболешинаА. В.AboleshinaA. V.

Аболешина Александра Вадимовна

115522, Москва, Каширское шоссе, 34а

Aleksandra Aboleshina

115522, Moscow, Kashirskoye Highway, 34A

ФГБНУ «Научно-исследовательский институт ревматологии им. В.А. Насоновой»РоссияV.A. Nasonova Research Institute of RheumatologyRussian Federation202431102024625494500Copyright © Аболешина А.В., 20242024Аболешина А.В.Aboleshina A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://rsp.mediar-press.net/rsp/article/view/3635

Ревматоидный артрит (РА), начавшийся у пожилых пациентов, отличается от РА с дебютом в более раннем возрасте тяжестью течения, активностью, ответом на терапию и исходами, что позволяет предполагать наличие особого фенотипа РА с началом болезни в пожилом возрасте. Однако трудности ведения пожилого пациента с РА обусловлены не только особенностями основного заболевания, но и другими факторами: мультиморбидностью, полипрагмазией и гериатрическими синдромами (саркопения, старческая астения, падения, когнитивный дефицит, инконтиненция). Такое сочетание клинических состояний не только значимо отягощает течение основного заболевания, но и усложняет выбор тактики ведения пациента в целом. Имеющиеся сложности курации пожилых пациентов с РА пока не послужили поводом к формированию общепринятого подхода, однако для решения данного вопроса была предложена комплексная гериатрическая оценка (КГО). КГО представляет собой диагностический процесс, включающий оценку физического, психоэмоционального статуса, функциональных возможностей и социальных проблем пожилого человека с целью сохранения его независимости, общего функционирования, а также оптимизации медицинской и социальной помощи.

The onset of rheumatoid arthritis (RA) in the old age differs from that at an earlier age in terms of severity of course, disease activity, response to therapy, and outcomes, which has led to the suggestion of a specific phenotype of RA with onset in old age. However, the difficulties of managing the elderly patient with RA are not only due to the specific features of the main disease, but also due to other factors: multimorbidity, polypharmacy and geriatric syndromes (sarcopenia, senile asthenia, falls, cognitive deficit, incontinence). Such a combination of clinical conditions significantly exacerbates not only the course of the main disease, but also complicates the decision-making process regarding the optimal tactics for the overall patient management. The existing difficulties of managing elderly patients with RA have not yet led to the formation of a generally accepted approach; however, to solve this problem, a comprehensive geriatric assessment (CGA) has been proposed. CGA is a diagnostic process aimed at evaluating the physical, psycho-emotional status, functional abilities and social problems of the elderly person in order to keep their independence, general functioning, as well as to optimize medical and social care.

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