[A model for assessing and correcting the risk of developing pressure ulcers in the system of long-term care for geriatric patients with limited mobility.]

The article is devoted to the results of the third stage of the scientific and practical project on the introduction of advanced social practices based on innovative gerontotechnologies into the system of long-term care for geriatric patients. It has been established that senile xerosis or skin «frailty¼ occurs in 75% of the population over 65 years old, when increased dryness of the skin leads to peeling, the formation of microcracks, the appearance of senile itching, sleep disturbances, the development of pressure ulcers and, as a result, a decrease in motor activity. During the project, a tactic was developed for the care of «frail¼ skin in patients with senile xerosis and the risk of pressure ulcers. The article presents information about the current problems of diagnosis, correction and prevention of pressure ulcers in patients with limited mobility of elderly and senile age. The results of a comparative analysis of the severity of pressure ulcers and their impact on the quality of life in the system of long-term care for geriatric patients with limited mobility before and after the use of Cicalfate+ Eau Thermale Avène («Pierre Fabre¼, France) emollient were presented. A model was built and practical recommendations were given on the use of the most informative and adequate scales for predicting and assessing the risk of developing pressure ulcers in patients of older age groups.

[Current problems of polypharmacy in geriatric patients when taking drugs with a risk of photosensitivity.]

The article presents an overview of the current problems of polypharmacy in geriatric patients when taking drugs with a risk of photosensitivity. The article contains information about emerging adverse drug reactions, as well as methods for diagnosing, correcting and preventing phototoxic and photoallergic reactions in patients of older age groups. The main aspects of dermatological support in the system of long-term care for geriatric patients when taking drugs with a risk of photosensitivity are outlined. Clinical signs of senile xerosis and skin manifestations of adverse drug reactions were studied when taking drugs with the risk of photosensitization before and after the use of a photoprotector in elderly patients.

[Implementation of advanced social practices based on innovative gerontotechnologies in the system of long-term care for elderly and senile patients.]

From 2017 to the present a scientific project «The use of dermatoprotectors to improve the quality of life of geriatric patients with age-associated xerosis (AAX)¼ has been realized as part of a typical model of a long-term care system in order to introduce the innovative gerontotechnologies as advanced social practices in further optimization of social and medical care for elderly and senile patients in Leningrad Region. The article presents the results of a comparative analysis of the effectiveness of the dermatoprotectors application in the improvement of the quality of life, prevention and correction of AAX. The AAX clinical manifestations have been studied before and after the emollients use. The cohort under study has included geriatric patients with senile asthenia from seven institutions of social protection of the Leningrad Region. In the foreign literature, such patients are called «fragile¼. The data thus obtained indicate that AAX as a manifestation of skin «fragility¼ during aging can be considered as a component of the geriatric syndrome of senile asthenia in patients of older age groups. The development of skin «fragility¼ significantly reduces the quality of life of geriatric patients and requires timely prevention and correction with adequately selected dermatoprotectors.

[Quality of life and physical activity among elderly and old people.]

This article presents the results of the identification of the main causes of physical inactivity among the elderly and the assessment of the effectiveness of the inclusion of regular Nordic walking into the preventive system for the elderly in order to improve the quality of life. A comparative analysis of the quality of life was used among elderly and old people, regularly engaged in Nordic walking (intervention group) and leading a physically passive lifestyle (control group). It was established that regular physical activity allows the improvement of the quality of life and positively affects health in groups under study, but it is the elderly people who represent the most physically inactive part of the population. The main reasons for the physical inactivity among older people are the presence of diseases, fear of injury and falls, lack of energy and weakness, low level of motivation, lack of partners or friends for joint activities, etc. The above studies have shown that regular practice of Nordic walking improves the quality of life for both elderly and old people. It was evidenced by the results of the SF 36 questionnaire analysis when we compared not only intervention and control groups but the age differences in the quality of life in all groups under study. After 12 months of regular Nordic walking it was registered an increase of the quality of life estimated on the scales of role-playing physical functioning, overall health, role emotional functioning, vitality, psychological health, social functioning, which correlated both with the physical and psychological components of health. The results thus obtained make it possible to recommend Nordic walking as the most simple, accessible and at the same time effective type of physical activity for the elderly population, that helps to overcome the main causes of physical inactivity, restore the functional capabilities of the aging organism. Gerontotechnologies based on the regular activities of Nordic walking are one of the most effective ways to improve and maintain the quality of life and, as a result, the activity, mobility, self-care ability among elderly and old people.