- ECGI Blogger1
Congress of the European Geriatric Medicine Society - EuGMS 2021, Athens, 11-13 October 2021.
Report from Oct 12th
Contributor: Kseniia Eruslanova
Origin/Afiliation: Kseniia Eruslanova, MD, MSc. Russian clinical and research geriatric center
In October 2021, the European Society for Geriatric Medicine congress was held in the capital of Greece, Athens. The Congress was performed in a combined format: live + online. Given the ongoing epidemic of the new coronavirus infection, at the entrance, congress participants had to show a QR code about vaccination to be admitted to the halls. Another method of combating the spread of infection was the absence of breaks between lectures. The consequence of this decision was the reduction of communication and regular lateness of both listeners and members of the presidium if they wanted to change their location. The Congress lasted for three days.
The President's Lecture by Professor Benetos (President of the European Society for Geriatric Medicine) focused on telomeres and their contribution to aging. Telomeres have long been considered the clue to the phenomenon of longevity. According to Hallmarks of Aging, there are nine signs of aging: telomere shortening. Today it is clear that everything is much more complicated. In the study, it was shown that the "best" life expectancy in the owners of average or slightly more average telomere length. Telomeres that are too long increase the likelihood of neoplastic diseases (neoplasms). And "short" telomeres - the risk of degenerative diseases (coronary artery disease, aortic aneurysm). At a young age, short telomeres reduce the chance of longevity, but if a person lives with them to 90 years old, his life expectancy will be like patients with longer telomeres. And also, girls, if you want your child to have a better chance of a long life, choose an older man for the father's role (advice from Professor Benetos).
Procalcitonin is not only an expensive test for diagnosing sepsis but a good marker for assessing the effectiveness of antibiotic therapy and resolving the issue and its discontinuation, for example, in pneumonia. In general, this analysis allows reducing the duration of the course of treatment by 1-3 days, which reduces the patient's risk of developing pseudomembranous colitis caused by Clostridium Difficele (7).
One of the symposia was organized by SIG (special interests group of EuGMS) on rehabilitation. The first results of the COGER study were presented - rehabilitation of elderly patients hospitalized due to a new coronavirus infection: on average, it takes 25-35 days for the rehabilitation of an older adult to return to their level of autonomy functioning, which they had before hospitalization. Unfortunately, not all of them managed to reach the level they had before hospitalization, and about 20% were unable to continue living independently and were forced to move to nursing homes.
Another symposium was devoted to nutrition in nursing homes in Europe, where geriatrics is just developing. Tunisia shared its experience of involving older guests in cooking: once every few weeks, cooking masterclasses are held, in which the elderly are happy to participate. Turkey has shown that by the way a person prefers to eat (alone or in a company), one can suspect that a person has depression. And the nutrition of the elderly in the Russian Federation is characterized by high-calorie content.
One of the controversial issues in geriatrics is blood pressure control in elderly patients: once again, we talked that if everything is clear with "strong" patients - we lower blood pressure according to the recommendations, then with "fragile" patients - there is no data. The main thing is not to forget about orthostatic hypotension.
Another lecture was devoted to new technologies in the treatment of parkinsonism: brain stimulation with an implantable device is a practical thing (8).
Can nutrition affect cognitive function and dementia? If a diagnosis of dementia has already been established, dietary adjustments cannot cure but may slow down the progression of the disease. For this, patients are recommended a diet containing vitamin E, phosphatidylcholine, medium-chain fatty acids, ketogenic acids (decanoic, octanoic). These products are neuroprotective. There is evidence that folates, flavonoids, multi-antioxidants, omega-3 acids, fish, wine, coffee, tea, the Mediterranean diet, and exercise reduce cognitive deficits in patients with mild cognitive impairment. In general, physical activity is not only the prevention of cardiovascular diseases but also cognitive impairment and dementia (9)
Osteoarthritis is a disease that does not cause death but reduces the quality of life and increases the risk of developing CVD. In the UK, 50% of OA occurs in large joints such as the knee and hip. The best, most effective, and cheapest therapy for OA is weight loss and regular exercise. Unfortunately, this is also the most challenging therapy. It's easier to take a magic pill, which, sadly, is not yet available. Glucose amines and chondroitin sulfate are not more effective than placebo. To relieve pain, you can use NSAIDs (it is unforgettable to remind the patient of adverse reactions: sodium retention (CHF decompensation) and gastric ulcer). Paracetamol is not as effective and, unfortunately, even slightly more dangerous than NSAIDs (do not forget an overdose of paracetamol causes acute fulminant hepatitis, which is a short time leads to death of the patient), take/prescribe with caution.