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The first day in Athens: Sunny and Rainy
Contributor: Kseniia Eruslanova
Origin/Afiliation: Kseniia Eruslanova, MD, MSc. Russian clinical and research geriatric center
Today October, 11, the 17th EuGMS Congress in Athens, Greece, was opened.
The keynote lecture was about Medeterenian Diet and Longevity. One of the six blue region zones (the places with the highest centenarians) is Ikaria, Greece. The Island, where people forget today. One of the explanations is this Medeterenian Diet (MD). MD is not only about food (excellent and tasty: vegetables, fruits, fish, and olive oil). It is also a lifestyle, a way how the people think. And this diet is working: people who follow this diet are less likely to have CVD, stroke, MI, type 2 DM, metabolic syndrome, and breast cancer.
One of the following sections was about small vessel diseases (SVD) of the brain. Clinical presentation is variable from ischemic and hemorrhagic strokes to vascular and Alzheimer's dementia and apathy, fatigue, and delirium. For diagnosis can be used MRI (and a little bit CT). The problem is treatment is still a little bit controversial. However, since May 2021, we have official guidelines for this condition: https://journals.sagepub.com/doi/full/10.1177/23969873211012132)
The next symposium was about vaccination and how it essential with older adults. Vaccination against pneumococcal infection, flu, and herpes zoster protects from disease and decreases the risk of MI and stroke.
And a few HOTLINE studies:
AAA (unpublished data)- statins therapy prevents the development of vascular stiffness. And what is exciting nobody can not explain it: statins do not affect blood pressure, lipid level does not correlate with vessel stiffness. Is it the other side of the pleiotropic effect of statins? "sugar-lowering medicine" does not affect vessels stiffness. Also, a question, usual patients with DM have a higher wall stiffness. But the other finding of the study highlights the role of wall thickness: if CAVE increased by 1 point, the cardiovascular risk increased by 30%.
Sleep disorder in mild cognitive impairment: this 505 patients (10,8% dementia, 32,4% mild cognitive impairment. during the study, the sleep pattern was evaluated by actigraphy: patients with MCI have the same sleep pattern as normal control, while patients with AD sleep longer. If you want to learn more, there is a link to papper:https://onlinelibrary.wiley.com/doi/full/10.1111/jsr.12864.
The session on sarcopenia was also very impressive. The stat analysis in most European countries revealed a low percentage of screening for sarcopenia and even less for diagnosis, while only half of the diagnosed patients received treatment. In terms of older hospitalized patients, the data was shown on progressive skeletal muscle decline after seven days in bed and even more rapid loss after discharge, which shows the need for timely physiotherapy and rehabilitation. SARC-F questionnaire, unfortunately, does not seem to be a choice with a sensitivity of less than 40%. It was recommended to stick with handgrip strength and DEXA for visualization. "You are what you eat," - so we should ensure that older patients will get enough protein, with a maximum recommended dose of up to 2 g/kg for severely ill individuals.
See you tomorrow in sunny and rainy Athens. If you are here, do not forget an umbrella.