Report from Oct 11th
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 main lecture was devoted to the "heritage of Greece" - the Mediterranean diet. The guest speaker was Antonia Trichopoulou, President of the Hellenic Health Foundation and a leading nutritionist in the European Union. Most of her work is explicitly devoted to the Middle-Sea Diet. In particular, she was one of the initiators of the EPIC-elderly study, one of which was to evaluate the effectiveness of this diet on the elderly. In the study, it was shown that the Mediterranean diet increased life expectancy in the elderly, reduced the risk of cardiovascular events, type 2 diabetes, metabolic syndrome, and colorectal cancer (1,2).
On the same day, there were several exciting symposiums.
One of them was dedicated to the disease of small vessels of the brain. Abroad (in particular, in the USA and Western Europe), this disease was not recognized for a long time. However, with the development and, most importantly, the spread of modern diagnostic methods (mainly MRI), the disease received recognition and even its own recommendations (3). The recommendations contain information about the disease, offer diagnostic, prophylactic, and treatment guidelines (with the level of evidence of prevention and treatment, the truth is not simple, since there is a lack of RCTs and, as a result, the level of evidence for the level of lieder-opinion). But in general, this is probably progress - the disease is officially recognized.
Another neurological report focused on sleep patterns in elderly patients with and without cognitive impairment and with dementia. A group of researchers from Crete presented the results of their work: all patients underwent a polysomnography study. In general, the sleep pattern of patients with mild cognitive impairment is closer to that of contaminated patients than those with dementia (in their case, Alzheimer's). (4)
Several symposia have been devoted to sarcopenia. First, the SARC-F questionnaire was discussed, which has been recommended for screening sarcopenia since 2019. Recent studies have shown that its sensitivity is approximately 30-40%, and now it is not recommended to use it for screening. It is better to carry out dynamometry, and based on its results, direct the patient to the BIVA and/or densitometry in the TOTAL-body mode.
Secondly, new data were presented on the use of ultrasound in the diagnosis of sarcopenia (5). Since 2018, the results of the SARCUS study have been published. Today, it is clear that ultrasound technology can be used to diagnose sarcopenia. However, a lot of work still needs to be done before introducing this research method into routine practice. In particular, the creation of standardized research protocols is still required. But the work is moving forward, and we must all be mentally prepared for the fact that in the coming years, we will send patients for an ultrasound to exclude/confirm sarcopenia.
At another symposium, the DAMAGE-SCORE scale was presented - an assessment of the risk of 3 and 12-month death of elderly patients hospitalized for emergency indications (in particular, in connection with a new coronavirus infection) (6).
In a pandemic era, the importance of vaccination cannot be overstated. One of the symposia was explicitly devoted to the significance of this process in elderly patients. An older adult's vaccination diary should include vaccinations against pneumococcal infection, herpes zoster, and annual flu vaccines. They protect against diseases and reduce the risk of cardiovascular events (in particular, heart attacks and strokes).
Speaking about the first day, one cannot fail to note a joint symposium with cardiologists: the results of an AAA (or triple-A study) study devoted to vascular aging and the effect of sugar-lowering and lipid-lowering therapy on this process were presented for the first time. The results are entirely unexpected: statin therapy - slows down the "aging of blood vessels" (before that, there was no evidence that lipid levels correlate with vascular age). Perhaps this is another of the pleiotropic effects of statins. At the same time, sugar-lowering therapy did not affect "vascular age," although sugar levels correlated with vascular age.
In short, one more stone in the piggy bank of the favorable properties of statins and many new "why" questions to which you will need to look for answers.