What are the main causes of syncope in older adults. How can syncope be diagnosed and treated in seniors. Why is syncope more common and dangerous in the elderly. What lifestyle changes can help prevent fainting episodes in older individuals. How should caregivers respond to syncope episodes in seniors.

What is Syncope and Why is it Concerning for Seniors?

Syncope, commonly known as fainting, is a sudden and temporary loss of consciousness accompanied by a loss of muscle tone. While it can occur at any age, syncope is particularly prevalent and concerning among older adults. But why exactly is fainting more problematic for seniors?

Syncope accounts for up to 3% of emergency visits and 1-6% of hospital admissions in North America. Notably, individuals over 70 years old have a significantly higher rate of syncope compared to younger populations and represent the majority of patients hospitalized for this condition. The increased frequency in seniors is largely due to age-related health changes and preexisting medical conditions that can affect blood flow to the brain.

Perhaps most alarmingly, syncope in older adults is associated with reduced survival rates, especially when not caused by vasovagal reactions. This makes it a critical issue for both seniors and their caregivers to understand and manage effectively.

What Are the Primary Causes of Syncope in Older Adults?

Syncope occurs when there is a temporary loss of blood flow to the brain. In seniors, several factors can contribute to this condition:

• Orthostatic hypotension: A sudden drop in blood pressure, often when standing up quickly
• Reflex syncope: Related to carotid sinus syndrome, which affects blood pressure regulation
• Heart disease: Various cardiac conditions can impact blood flow
• Neurological conditions: Issues affecting the brain and nervous system
• Dehydration: Insufficient fluid intake leading to reduced blood volume
• Polypharmacy: Side effects or interactions from multiple medications

Understanding these causes is crucial for proper diagnosis and treatment. Are certain causes more dangerous than others? Indeed, while some instances of syncope may be relatively harmless, others can indicate serious underlying health issues, particularly those related to heart conditions.

How is Syncope Diagnosed in Elderly Patients?

Diagnosing the underlying cause of syncope in older adults often requires a comprehensive approach. Healthcare providers typically follow these steps:

1. Detailed patient history: Understanding the circumstances surrounding fainting episodes
2. Physical examination: Checking for signs of underlying health issues
3. Blood pressure measurement: Assessing both lying down and standing positions
4. Heart evaluations: ECGs, echocardiograms, or other cardiac tests as needed
5. Tilt-table test: Monitoring symptoms as the patient’s position changes from lying to upright

In some cases, despite thorough testing, the exact cause may remain unidentified. While this can be frustrating, it often suggests that the condition is not severe. However, ongoing monitoring and management are still crucial in these situations.

What Treatment Options Are Available for Syncope in Seniors?

Treatment for syncope varies widely depending on the underlying cause. How do healthcare providers approach syncope management in older adults? The strategy typically involves addressing the root cause while also implementing preventive measures:

• Medication adjustments: Changing dosages or types of medications that may contribute to fainting
• Cardiac interventions: In cases of heart-related syncope, treatments may include pacemaker implantation or other cardiac procedures
• Lifestyle modifications: Implementing changes to reduce the risk of fainting episodes
• Orthostatic hypotension management: Recommending compression stockings, gradual position changes, and increased salt intake when appropriate
• Trigger avoidance: Identifying and avoiding specific triggers that may lead to syncope

It’s important to note that treatment plans are highly individualized, taking into account the patient’s overall health, specific symptoms, and lifestyle factors.

How Can Caregivers Help Manage Syncope in Older Adults?

Caregivers play a crucial role in managing syncope in seniors. What steps can they take to ensure the safety and well-being of those prone to fainting? Here are some key strategies:

• Implement fall prevention measures: Remove tripping hazards, install grab bars, and ensure good lighting
• Monitor medication compliance: Ensure medications are taken as prescribed and report any side effects
• Encourage proper hydration: Help maintain adequate fluid intake throughout the day
• Assist with position changes: Help the senior move slowly from lying to sitting to standing
• Recognize warning signs: Learn to identify pre-syncope symptoms like dizziness or lightheadedness
• Create a safe environment: Pad sharp edges, use soft flooring where possible, and keep frequently used items within easy reach

Additionally, caregivers should be prepared to respond quickly and appropriately if a fainting episode occurs. This includes knowing how to safely lower the person to the ground, elevate their legs, and when to seek emergency medical attention.

What Lifestyle Changes Can Help Prevent Syncope in Seniors?

While not all cases of syncope can be prevented, certain lifestyle modifications can significantly reduce the risk of fainting episodes in older adults. What changes can seniors implement to minimize their chances of experiencing syncope?

• Stay hydrated: Drink adequate fluids throughout the day, especially in hot weather or during physical activity
• Move carefully: Rise slowly from sitting or lying positions to allow blood pressure to adjust
• Exercise regularly: Engage in appropriate physical activities to improve circulation and overall health
• Manage stress: Practice relaxation techniques to reduce the likelihood of vasovagal syncope
• Wear compression stockings: These can help maintain blood flow in the legs
• Elevate the head of the bed: This can help reduce orthostatic hypotension upon waking
• Avoid triggers: Identify and steer clear of situations or activities that have previously led to fainting

It’s important to note that these lifestyle changes should be implemented under the guidance of a healthcare provider, as some modifications may not be suitable for all individuals depending on their specific health conditions.

When Should Seniors Seek Medical Attention for Syncope?

While occasional fainting episodes may not always require immediate medical intervention, certain circumstances warrant prompt attention. When should older adults or their caregivers be particularly concerned about syncope?

• First-time occurrences: Any first episode of syncope should be evaluated by a healthcare provider
• Frequent episodes: Recurring fainting spells may indicate an underlying health issue
• Associated symptoms: Syncope accompanied by chest pain, shortness of breath, or irregular heartbeat requires immediate medical attention
• Injuries: Any fainting episode resulting in injury should be assessed by a medical professional
• During physical activity: Syncope occurring during or immediately after exercise is particularly concerning
• Prolonged unconsciousness: If the individual doesn’t regain consciousness quickly, emergency services should be called

It’s always better to err on the side of caution when it comes to syncope in older adults. Given the potential for serious underlying causes and the risk of injury, prompt medical evaluation is crucial for ensuring the best possible outcomes.

The Impact of Syncope on Daily Life for Seniors

Syncope can significantly impact the quality of life for older adults. How does the risk of fainting affect seniors’ daily activities and independence? Here are some key considerations:

• Driving restrictions: Depending on the frequency and severity of syncope episodes, seniors may need to limit or cease driving
• Increased fall risk: The sudden loss of consciousness can lead to falls, potentially causing serious injuries
• Activity limitations: Fear of fainting may cause seniors to avoid certain activities or social situations
• Psychological impact: Anxiety about potential fainting episodes can affect mental well-being
• Need for supervision: Some seniors may require increased caregiver presence or monitoring

These impacts underscore the importance of proper diagnosis, management, and support for seniors experiencing syncope. By addressing the underlying causes and implementing appropriate safety measures, many older adults can maintain their independence and quality of life despite this condition.

The Role of Technology in Managing Syncope in Seniors

Advancements in technology are playing an increasingly important role in the management and prevention of syncope in older adults. How can modern devices and systems help seniors and their caregivers deal with this condition?

• Wearable devices: Smartwatches and other wearables can monitor heart rate and detect irregular rhythms
• Fall detection systems: These can automatically alert caregivers or emergency services if a fall occurs
• Medication reminders: Apps and smart pill dispensers can help ensure proper medication compliance
• Telemedicine: Remote consultations allow for more frequent check-ins with healthcare providers
• Home monitoring systems: These can track vital signs and alert caregivers to potential issues

While these technological solutions can provide valuable support, it’s important to remember that they should complement, not replace, regular medical care and personal attention from caregivers.

The Importance of Support Systems for Seniors with Syncope

Managing syncope in older adults often requires a comprehensive support system. Why is a strong support network crucial for seniors dealing with this condition?

• Safety: Having others nearby can provide quick assistance during fainting episodes
• Emotional support: Dealing with syncope can be stressful, and emotional backing is vital
• Practical help: Assistance with daily tasks can reduce stress and the likelihood of syncope triggers
• Medication management: Support in maintaining proper medication regimens is often crucial
• Advocacy: Family members or caregivers can help communicate with healthcare providers

Encouraging seniors to build and maintain strong social connections, whether through family, friends, or community groups, can significantly improve their ability to cope with syncope and maintain a good quality of life.

Nutritional Considerations for Seniors Prone to Syncope

Diet can play a significant role in managing syncope, particularly in cases related to orthostatic hypotension or dehydration. What dietary approaches can help seniors reduce their risk of fainting episodes?

• Adequate hydration: Ensuring sufficient fluid intake throughout the day
• Balanced electrolytes: Maintaining proper levels of sodium, potassium, and other electrolytes
• Small, frequent meals: This approach can help prevent post-meal blood pressure drops
• Limited alcohol: Reducing alcohol consumption, as it can contribute to dehydration and blood pressure changes
• Caffeine moderation: While some caffeine can be beneficial, excessive amounts may trigger episodes in some individuals

It’s important for seniors to discuss their diet with healthcare providers, as individual needs may vary based on underlying health conditions and medications.

The Future of Syncope Management in Geriatric Care

As our understanding of syncope in older adults continues to evolve, so too do the approaches to its management. What developments can we expect in the future of syncope care for seniors?

• Personalized risk assessment: Advanced algorithms may help predict individual syncope risk more accurately
• Targeted interventions: More specific treatments based on the exact underlying cause of syncope
• Improved diagnostic tools: New technologies may allow for easier and more accurate diagnosis
• Enhanced monitoring: Continuous, non-invasive monitoring systems for at-risk seniors
• Integrative care approaches: Combining traditional medical treatments with complementary therapies

These advancements hold the promise of improving outcomes and quality of life for seniors experiencing syncope. As research progresses, we can expect more effective and personalized approaches to managing this challenging condition in older adults.

Seniors and Syncope: The 411 on Fainting

If you’ve ever been around someone who has fainted—or if you’ve ever fainted yourself—you know it’s a frightening ordeal. Clinically known as “syncope” (pronounced SIN-co-pee), fainting is not only much more common in older adults but also associated with a reduced survival rate—and therefore of particular importance for senior caregivers. Here’s a closer look at syncope, along with what all caregivers need to know about caring for someone with this condition.

About Syncope

According to “Syncope in Older Adults” published in the academic journal Geriatrics and Aging, “Syncope is defined as a transient and sudden loss of consciousness with a loss of postural tone. Patients with syncope constitute up to three percent of all emergency visits and one to six percent of all hospital admissions in North America. Patients over 70 years of age have a much higher rate of syncope than their younger counterparts and represent the majority of patients hospitalized with syncope. Unless it is vasovagal, syncope is related to decreased survival.”

When people experience syncope—or “faint”—they lose consciousness and become unresponsive while their muscles go slack. Prior to this, some people feel dizzy or hear a buzzing sound in their ears. While most people recover spontaneously on their own from a fainting episode, there is cause for concern for several reasons. For starters, syncope is not a disease in itself but may be indicative of a more serious problem. Additionally, injuries can occur during the episode. 

What Causes Syncope?

Syncope results from a temporary loss of blood flow to the brain. While some causes are harmless, in other cases it can be life-threatening. In seniors, orthostatic hypotension (a sudden drop in blood pressure) reflex syncope (a side effect of carotid sinus syndrome), and heart disease are the most common causes of fainting. Conditions of the brain and nervous system, dehydration, and polypharmacy are all associated with syncope, according to HealthinAging. org. 

If someone for whom you’re caring has a fainting spell, immediate follow-up with his/her healthcare team is important as this can help determine any potentially dangerous underlying conditions. Based on a physical exam and patient history, the healthcare team will identify the most appropriate tests aimed at determining the cause of the episode. Tests may include blood pressure measurement, evaluations for heart disease, and a “tilt-table test,” which tracks changes in symptoms in positions ranging from lying down to upright. 

In some cases, the provider will not be able to ascertain the cause. While this can be disconcerting, it’s also good news as it most likely means the condition is not severe. 

Syncope Treatment and Management

Because syncope has many causes, treatments are equally diverse. In some cases, it may be as simple as making changes to medications, while heart-related factors may mandate aggressive medical interventions, such as a pacemaker.  

When syncope is caused by orthostatic hypotension, the healthcare provider may recommend simple changes to reduce the risk of fainting, including wearing compression stockings, sitting for a while and/or exercising your legs before getting up in the morning, elevating the head of the bed, and increasing salt intake. Furthermore, if your aging loved one’s syncope is linked with a certain “trigger,” avoiding these can also mitigate the risk of fainting episodes. 

If someone for whom you’re caring starts experiencing syncope, some lifestyle changes may also be in order. Depending on the circumstances and the laws of the state in which you live, driving may also be prohibited. Additionally, avoiding stairs and hard surfaces and implementing basic fall prevention precautions can reduce the risk of sustaining injuries during an episode. 

mmLearn.org offers a large library of free videos for caregivers of older adults, covering topics pertaining to senior care. Whether you are a healthcare professional or a family caregiver, if you are caring for an older adult we know that you will find mmLearn.org an essential learning and guidance tool for all of your caregiver training needs. For more free caregiver training materials, access our database of free online caregiver videos today.

Understanding Syncope In Seniors | Lakeside At Mallard Landing

Fainting episodes can occur at any age, although it is more likely in older adults due to their existing health conditions and deteriorating physical state. When the blood supply to the brain is diminished or interrupted, this results in syncope, often known as fainting. Before you send yourself or your loved ones off to a retirement community, you should understand syncope and the risks it poses.

Causes of Syncope

When there is a reduction in blood pressure, there is a lack of blood supply to the brain. This is known as vasovagal syncope and is one of the most common causes of syncope in older adults. It can happen even with minor actions, such as sitting for an extended period of time and then standing up rapidly. This causes the blood to settle in the lower half of your body due to the lengthy amount of sitting. To keep the blood flowing up to your brain, your heart has to work a little harder. However, as you become older, this becomes more difficult and might result in dizzy spells.

Other causes of vasovagal syncope in adults include witnessing blood or having blood drawn, standing for extended periods of time, exposure to heat, anxiety, and dehydration. The most prevalent causes of syncope are neurally-mediated, such as vasovagal syncope and orthostasis. While less prevalent causes of syncope, such as cardiac structural disease and arrhythmia, have worse results than neurally-mediated and orthostatic causes.

Symptoms of Syncope

Knowing what causes syncope in older adults might help you be more observant and avoid factors that may cause you to collapse. However, because this is not always possible, it is necessary to be aware of symptoms that suggest you may pass out. Feeling lightheaded, tunnel vision, nausea, impaired vision, or a cold, clammy sweat are among some of the common symptoms.

Can Syncope Be Treated?

There is no actual syncope remedy; instead, concentrate on managing the symptoms. While syncope is normally safe, the danger rests in what happens around you when you are about to faint. You would not want to bang your head when you fall or have a fainting spell at the top of the stairs, for example. Your doctor may order certain tests to see whether the fainting spells are a sign of a more serious cardiovascular issue, such as cardiomyopathy. It is critical to be aware of the illness and to recognize when an episode is approaching so that you can remain safe.

What to Do if Someone Faints?

Seek emergency medical attention if an older adult loses consciousness, especially if they have cardiac issues, are prone to fainting spells, or have lost their consciousness and fell as a result of syncope. If you are able to get involved, there are several actions that you do to ensure their safety before the relevant authorities arrive. When someone has fainted but is continuing to breathe, try to lay them on their back, with their feet about a foot above their heart. This will help to restore and improve blood flow to your loved one’s brain.

An aging person: about what happens to us with age

An aging person: about what happens to us with age

What is an aging person and what is a developing person? The article focuses not on biochemical and morphological aspects, but on the personality – on the process of individual development of a person, because it never stops. There is no need to think that after adolescence, a person reaches a plateau, as scientists call “acme”, the highest point of development, and then degrades. Aging is not degradation. This is a process of continuing development, a very peculiar one.

Normal aging, according to our psychological school, is a process of continuous, progressive, uneven, complex growth of various limitations. There are purely physiological ones: hearing is reduced, specific forms of diseases appear that are not actually diseases, but there are normal symptoms of aging associated with movements, muscles, sensory systems, psychology, and so on, and, of course, social restrictions arise that are in the individual consciousness of an aging person are refracted and turn into existential ones. The unevenness of the process gives rise to individual differences. Modern methods of scientific research, prone to statistical processing and quantitative analysis of data, unfortunately, do not help to reveal the essence of the mechanisms that lie behind it, because aging is extremely individual.

Why? Speaking rather roughly, here is a child. As soon as he is born, he immediately enters the society where he is looked after, but nature is arranged in such a way that a certain program is laid in the genetics of a new person that gives him a minimum range so that he survives. Therefore, early ontogeny, that is, early individual differences from birth to preschool age, is sufficiently programmed. We know the standards: when a child should be able to hold his head, say the first word, what kind of words should be, when he should have phrasal speech, when he should start walking, crawling, and so on. If there are deviations in the standards, we say that this is abnormal, pathological, something needs to be done about it – the correction should be medical, because these programs are biological. In adulthood, development is already more directed, social: a person shows his own activity, and so on. He reaches the third age, that is, the age of aging, with already very serious baggage – knowledge, experience, experiences, psychological trauma, views, meanings, values. All this colossal baggage, of course, makes the natural biological program very noisy. Therefore, aging is individual precisely because of individual experience. Thus, we are not very good at finding biological causes using natural science methods. Therefore, all the data on individual differences that I will give are clinical. That is, collected not on patients, but through long-term, many years of observation – including our department and me.

Nevertheless, it is possible to distinguish individual differences, which we call style, variant or type, that is, to distinguish a certain typology of normal aging based on how the brain works. In the 1930s and 1950s, a prominent Soviet researcher, psychologist Alexander Romanovich Luria, discovered the science to the world, which he called neuropsychology. She was born in the Soviet Union and is accepted all over the world. Indeed, this is our achievement, one of the few that is definitely ours. Luria studies patients with local lesions of the brain, presenting various kinds of tests, showing that when certain structures are damaged, certain symptoms of violations of higher mental functions arise, such as memory, thinking, attention, speech, and so on. He concluded that if a patient is given a certain test that will demonstrate certain disorders of mental functions, then these zones are responsible for the implementation of these mental functions.

In the 1970s and 1980s, Natalya Konstantinovna Korsakova, a student of Alexander Romanovich Luria, began working at the Mental Health Research Center, where she was offered to use the methods developed by Luria to diagnose Alzheimer’s disease in order to understand exactly how the brain is affected. And indeed, by presenting these tests, the Lurian methods that were developed for people with brain tumors, she shows that patients with Alzheimer’s disease experience very similar symptoms, similar to those that occur in patients with tumors of the parietal, frontal lobes. , temporal, subcortical structures of the brain. Korsakova concludes that in Alzheimer’s disease and other forms of senile dementia, severe mental disorders of senile age, specific cognitive impairments are observed. This means that this pathological process, not tumorous, but atrophic, spreads in each individual case with a different disease to certain areas of the brain. This is how the science of neurogerontopsychology is born. Scientists became interested in what happens in old age in the norm. Having studied more than 300 healthy people from 50 to 100 years old who have never visited doctors for mental health and neurological problems, Korsakova identifies various neurocognitive styles, a typology of normal aging. It shows how we and our psyche are aging in connection with the work of the brain. These data are indirectly confirmed by Western studies using neuroimaging, functional tomography, positron emission tomography, and so on.

What is aging phenomenologically?

First, of course, this is a slowdown in the pace of activity. Latency is growing, people at the third age begin to work more slowly. This slowness becomes especially evident at the initial stage of activity. It becomes especially difficult to quickly extract information, to link it. You need to be able to negotiate with your memory after 55 years, so that it gives out what you need.

Secondly, the person begins to work as a single-channel system. If he reads a newspaper, then the TV no longer hears and does not think about things that are not related to this newspaper.

As for the speech sphere, an elderly person should speak not only slowly, but also in a low voice. Not necessarily loud, although age-related hearing loss can also occur, but a velvety baritone or even bass will be learned better than tenor and falsetto. This is a purely sensory thing, scientifically proven.

Fourth, tempo characteristics. Speech information can be absorbed more slowly than non-verbal information. There is a certain imbalance, stealing the right hemisphere in favor of the left. The left hemisphere begins to work more intensely due to the fact that it may lose some right hemisphere functions. But nevertheless, not always and quite fragmentarily, therefore, for example, music is assimilated well, and listening to songs of youth actualizes the deep layers of memories.

The tactile sphere literally comes to life, that’s why people love sorting things, dusting, so it’s better to give the elderly textured gifts, textured ones – this also actualizes the thresholds of memory layers.

About memory. Access to direct memories of what happened now is becoming more closed. Access to early memories of youth, youth and even childhood is opened. They become brighter and more distinct. Traces of memory are not erased: we remember everything, we just do not always have access to it.

And finally, this is a decrease in the ability to learn new things and difficulties in setting creative tasks. Not because the person becomes demented, but because there is not enough energy to keep the creative process going, which, as you know from all the metaphors, must gusher.

Types of normal aging

This typology is based on the concept of Alexander Romanovich Luria about the structures of the functional blocks of the brain. On the basis of his numerous studies, he divided the brain into three blocks not according to the morphological structure, but according to the roles that brain structures play for the implementation of higher mental functions.

Energetic neurocognitive style of aging

The most common, universal. It is associated with a decrease in the functions of the energy supply of mental activity: people become slower, they experience the “on-off” phenomenon – “on-off”. That is, a person starts reading a book, it’s difficult, it’s not vulgar, he closes it, goes to the kitchen and helps his wife cook borscht, that is, it is activated. These fluctuations can be observed quite gently, they should not disturb the adaptation. With vascular lesions of the brain, this effect can disrupt it. That is, a person may not cope with the task in the “off” state, and in the “on” state, he may become too excited. He cries, he laughs. There are such clinical examples.

In addition, this is a narrowing of the volume of activity, a single-channel system of perception, slowness of memory traces and fatigue – non-specific characteristics of aging, not risk factors. The most important thing is that the cerebral cortex works well. That is, a person can come up with it himself, learn from past experience, plan, for example, that it will take him such a long time to get to the clinic, and in order to visit his grandchildren, such operations are needed; he can plan the day in a specific way. Inhibition, the inaccessibility of memories that are needed right now, means that you need to write it down, and a person understands all this. The risk factor that can lead a person to maladjustment is, of course, stress. Since the subcortical structures are emotions, stress resistance, the ways to regulate one’s emotions become insufficient. That is, there may be emotional problems.

This is also an exacerbation of bodily ailments. The most malignant one, which really unsettles a person and puts him into a state of disadaptation, anxiety, depression, is the femoral neck. Such a person needs special attention; perhaps professional psychological support. I’m not talking about cataracts and other purely age-related things – they, of course, also require special attention.

Spatial neurocognitive style of aging

The second type is a decrease in the ability to orientate in real and internal space. Already a specific type of aging, in which it becomes very difficult to holistically perceive various things. Reading even a short story and understanding what the point is can already become a problem. You must first read one paragraph, comprehend it, remember it, take a breather, then the second and so on. Technically, you can read a story, a person will not be exhausted, but he will not understand it. And the most important thing is “disadaptation” in the new space. Please note this is not a spelling error. That is, the person is not completely lost, but it is difficult for him in the new space, he begins to grab his right hand, thinking: “The right hand means I need to go to the right.” They have a marker that is actually programmed: “I write with my right hand,” which means you need to orient yourself to the right. They can stray for a very long time, but not in the sense that they are really lost, but because they have such difficulties in a new space. In the old familiar space, everything can be quite safe.

That is, the risk factors here are a change in the environment, for example, emigration. Our colleagues, Russian psychologists abroad, at one time published articles in journals devoted to Russian emigrants in France and the USA. They describe these phenomena on a very large scale, also in connection with the linguistic side. For example, the phenomenon of “pathological nostalgia”: an emigrant woman believed that she was in her Moscow apartment, she saw people from that life. These were not hallucinations due to mental illness, but a temporary condition, stress, culture shock. It has to do with the right hemisphere.

The important thing to understand here is that these kinds of things can be very similar to Alzheimer’s disease, but they need to be distinguished. Here are the statistics. Schizophrenia is 1%, but 10% is Alzheimer’s disease, where 4% is early Alzheimer’s. In our clinic, these are all women 40 years old. I remember the last case: 40 years old, a nurse and really severe symptoms associated with profound memory impairment. If you want to understand what it is, watch the amazing film “Still Alice” about early Alzheimer’s. What happens to a person is shown with maximum reliability, with deep psychologism, insight into the essence of this painful condition. After 55–60 years old, this is already classic Alzheimer’s, and the later one is called senile (lat. “senile”). Scientists say it’s genetically programmed. Unfortunately, there are no methods to identify a person’s risk of developing this disease before the disease occurs. The genetic constellation leads to an imbalance of acetylcholine and other neuropeptides, which leads to the formation of Alzheimer cells, that is, atrophy of nerve cells in certain departments, which leads to the fact that these cells do not work and the brain functions poorly.

There is no cure for Alzheimer’s disease: all drugs that are prescribed are symptomatic and do not significantly improve the state of mental functions. And even more so, unfortunately, they do not prevent further malignant development (after the onset of the disease, a person lives no more than 10 years). This is gross exhaustion, that is, a person cannot actively work for 45 minutes, gross memory impairment, inability to remember material, spatial orientation disorder, confusion, that is, a person may not understand where he is, on the street or at home. You could once watch a grandfather in slippers on the street with an absolutely bewildered expression on his face, who sometimes screams, tries to call for help. Of course, this is not yet a reason to diagnose him with Alzheimer’s disease, but this is a pathological condition that very often accompanies it. Spatial disturbances come to the fore, that is, people cannot remember where the toilet is, where the kitchen is. But it is worth noting that their facade of personality is preserved, they experience this state, they are critical of it. Perhaps the whole tragedy lies in the fact that they understand that they are losing what makes up their personality. Because, according to one of the founders of Russian psychology, Sergei Leonidovich Rubinshtein, one of the central functions of memory is the structuring of personality. If memory disintegrates, all our experience disintegrates, the experience of communication with our personality, that is, the personality leaves.

Regulatory neurocognitive style of aging

This is not yet a pathology, but it is already a truly risky option when the anterior parts of the cerebral hemispheres age first. This is where self-control comes in. This is the most central symptom as the frontal lobes are involved. Luria calls the third functional block of the brain a block of programming, regulation and control of mental activity, therefore here regulation and control suffer first of all. When they weaken a little, this is still the norm – what we in everyday life call “gray hair in a beard, demon in a rib”: a person is over 60, and he believes that he, as a young man, can do his job, behave like a young man, dress in torn jeans, walk with a player, say: “I listen to Dima Bilan, I won’t listen to Shulzhenko and Utyosov, I’m not that old yet. ” There may also be sexualization of behavior.

In activities there may be problems with building plans, getting stuck at some points, inflexibility. Apathy, disturbance and decrease in motivation, which must still be preserved. Including the motivation to transfer semantic value experience to other generations: “Well, why should I call my grandson, he doesn’t need me. That I will get him.” Experience of failure, loneliness, changing living conditions – all this can be a risk factor. Emotional, brutal reactions may follow. Against the background of stress, an elderly person may think: “What is it, my son came, he stole my passport. I can’t find my passport, because he came, he wants to do something with me.” That is, crazy ideas arise, but against the background of some kind of stress.

The extreme case, the pathological prototype here is Pick’s disease – also a classic disease, the pole of Alzheimer’s disease. If the facade of the personality is preserved there, and the person is aware of and suffers from increasing cognitive impairment, then in Pick’s disease (or, as it is now customary to say according to the newfangled psychiatric classification, in frontotemporal dementia), the anterior sections of the cerebral cortex are dysfunctional. Such patients are emotionally blunted, passive, indifferent, inactive, lying down, doing nothing. They are impoverished in motor skills, writing, reading, counting and are not critical of what is happening, but they are euphoric, they are complacent, they can laugh. At the same time, they are absolutely inactive, empty, moral and ethical attitudes are lost. There may be stereotypes, perseverations, that is, obsessive actions, and gross cognitive impairments, that is, speech disorders, grammatical structure, impoverishment of speech production, unwillingness to speak, build a detailed statement, and so on. First of all, and at the beginning, this emotional and personal dysfunction appears, at a later stage, some cognitive impairments are added. Now this is maladjustment.

What prevents pathological aging?

People who have been engaged in intellectual work throughout their lives suffer from dementia of late age less. Gymnastics technologies for the brain have been developed separately, that is, if there are already some limitations in the cognitive sphere, then you can turn to psychologists who will develop an individual training program. Of course, I know old people who learn poetry themselves. It’s like a separate activity: we got up, had breakfast, walked the dog, then a couple of hours to learn a new poem, called a friend in the Moscow region, read it by heart, played chess on the phone, which is also good, you can see how e2-e4 correlate, then you can eat again, then walk the dog again. That is, it is a planned activity, where there is a cognitive and intellectual component to maintain tone. The tone is maintained in this way – through intellectual activity.

In people who constantly maintained physical activity, the risk of dementia of late age decreases due to the fact that the metabolism works better, which means that atherosclerotic plaques do not form, sugar normalizes, and so on. That is, things that are purely connected with the vessels no longer make a pathological contribution.

Mode. It has been shown that people who drink alcohol are more likely to suffer from dementia of late age. The so-called Mediterranean diet is useful: proteins, seafood, phosphorus, fresh vegetables. Those who have a clear pattern of sleep and wakefulness get sick less.

And then pure psychology. People who experienced psychotraumas and did not turn to a specialist with these psychotraumas, did not get rid of them, suffer more often. People who experienced a lot, but mini-stress, that is, who had vigorous activity, who lived in constant stress, suffer less from Alzheimer’s disease and other dementias.

Reflective people (who reflect on their inherent neurocognitive style) can use this. As in the example with borscht. If he has a spatial option, but he remembers well which ingredients to put. And she has the first option, she doesn’t remember it, but her frontal lobes are intact, that is, she remembers the procedure: first you need to pass, then lay out, and so on. And now they cook borscht together, because they understand that it is impossible to cook it not together. That is, they really bring freshness to their relationship, because they go to a new level. They form a joint activity, which was not.

And finally, the possibility of realizing development goals. Of course, you understand very well: those old people who have grandchildren are happy. Loneliness gives rise to all these forms of maladjustment. Even if we have a lonely representative of the third age, but he has all this (that is, he was intellectually active, he reflects on what is happening to him), then he will be able to find compensation strategies through purely social things like clubs or social programs.

An elderly person is not a “relic”, but a contemporary | Federation Council of the Federal Assembly of the Russian Federation

The calendar reminded: October 1 is the International Day of Older Persons. After reading this entry, I thought about how the social status of those whom we call the elderly, and their role in society, and the very concept of “elderly people” have changed over the past decades. Now this term is used more and more carefully, correlating with how an elderly person feels and defines himself. And this is not just a tribute to political correctness. Modern people, having crossed the threshold of 60 years, which is officially considered the starting point of old age, for the most part do not meet the traditional idea of ​​old age. They are cheerful, active, energetic, set to continue their professional activities.

The calendar reminded: October 1 is the International Day of Older Persons. After reading this entry, I thought about how the social status of those whom we call the elderly, and their role in society, and the very concept of “elderly people” have changed over the past decades. Now this term is used more and more carefully, correlating with how an elderly person feels and defines himself. And this is not just a tribute to political correctness. Modern people, having crossed the threshold of 60 years, which is officially considered the starting point of old age, for the most part do not meet the traditional idea of ​​old age. They are cheerful, active, energetic, set to continue their professional activities.

Extending the active period of human life is one of the greatest achievements of modern civilization. For centuries, old age came early, around the age of 40. So, in N. Gogol we read: “The door was opened for us by an old woman of about forty.” The “old” husband of Anna Karenina was less than 50 years old. The “old pawnbroker” from F. Dostoevsky’s novel “Crime and Punishment” by today’s standards is generally a young woman – 42 years old. Old age was associated mainly with poverty, illness, and loneliness. Which is fixed in the famous Russian proverb “Old age is not joy.”

Today, in many countries, primarily in those that are commonly called developed, advanced, the picture is qualitatively different. And this is due to the fact that the state directs the growing technological, economic, social achievements of modern civilization to improve the lives of older people. Including – to create conditions that allow them to continue to feel like full members of society, to realize their intellectual, professional, creative potential, to play an active role in various spheres of life. We read texts that talk about the high degree of social protection of older people in developed countries. Television, cinema, the Internet show films, videos, photos in which these people appear athletic, cheerful, well-groomed. They travel the world. They often buy more goods and services than young people.

All of this is true. But not all. Developed pension systems operate in only about a third of countries, where only about 30% of the world’s population lives. The well-being of pensioners is largely formed due to an effective system of pension savings carried out by the citizens themselves. With the support of the state, employers. But the main problem is that it is becoming increasingly difficult to maintain this level. The increase in life expectancy contributes to the “aging” of the population of both individual countries and the planet as a whole.

I will give you figures that give an idea of ​​the scale of these processes. Since 1950, the number of people over the age of 60 has quadrupled to over 810 million. And it is increasing by 58 million annually. If this trend continues, the number of older people will reach 1 billion by 2020 and 2 billion by 2050. In developed countries, where the average life expectancy is now about 78 years, aging is even faster. For example, in Japan, where the average life expectancy has reached 80 years, the proportion of older people in the population is 32%. In Sweden, one of the “oldest” countries in Europe in this sense, this indicator is 25%, which is also quite a lot.

We also have the problem of population aging. The proportion of older people in Russia is about 19%. There is no doubt that the increase in average life expectancy with the extension of its active period is an integral indicator of the effectiveness of the state’s social policy. Our country has the right to consider it a success that after a long period of decline in average life expectancy, it began to grow again, and in 2015 it exceeded 71 years. We will continue to focus our efforts on consolidating and strengthening this trend. And at the same time, we must take measures to address issues that are put on the agenda by an increase in both the absolute number and the proportion of older people in the population structure.

The main problem, on which I have had to speak more than once, is the objective need to raise the retirement age. Russia is aging: if in the 1980s there were two people of retirement age per 10 employees, now there are 6 pensioners per 10 employees. As I said, this is a worldwide trend. There are few states on the planet where the retirement age would be the same as in our country. As a rule, it is higher. So, in Israel it is 67 years for men and 62 years for women, in England 66 and 66, respectively, in Switzerland – 65 and 64. There were no big problems with raising the retirement age either in these states or in others. . The main thing that helped such a painless transition is the open dialogue between the authorities and citizens, the transparency of the actions of the authorities, the gradual, phased process.

I think we should do the same. I do not support the calls of “hotheads” in power to start the process of raising the retirement age immediately, as early as next year. But I do not support those who, in principle, oppose this increase. We need to balance the pension system and provide decent pensions. But not with a “revolutionary leap”, but with preparatory administrative-financial and explanatory work.

I consider it a task of great national importance to expand the opportunities for older people to remain in demand, not to sit, roughly speaking, on the mound, to continue working. Of course, we are talking about those of them who are willing and able to live an active life. In my opinion, our country is losing a lot due to the fact that the potential of older people is poorly used. One of the main reasons for this is the general atmosphere of a kind of distrust towards them, they say, what can they do? However, already in antiquity there was an understanding of the controversy of such a view. The outstanding ancient thinker and orator Cicero wrote: “Can it be said that old age makes us incapable of business? What business exactly? To those that are characteristic of youth and require strength. But isn’t there nothing that an old man would be capable of, that could be done with a sound mind and a weakened body?

In the era of rapid scientific and technological progress, a reduction in the share of physical labor and the prevalence of mental labor, this position, expressed two thousand years ago, is more than relevant. Many older people today are able and willing to work. We need to change not only the very attitude towards veterans in this regard, but also carefully look at the existing legislation, by-laws. Consider measures to create conditions for this social group to improve the level of qualifications, acquire new professional skills, expand the practice of remote work, etc. In order to eventually reach an optimal solution to this issue.

I believe that it is necessary to intensify the work that is currently being carried out by legislators together with the Government of the Russian Federation, the Ministry of Labor and Social Protection, other interested ministries and departments in pursuance of the order of the President of the Russian Federation following the meeting of the Presidium of the State Council “On the development of a system of social protection of elderly citizens age.