Medical and Social Expert Evaluation and Rehabilitation

BACKGROUND: With an increase in the average life expectancy of the population, the number of elderly people is increasing, and issues related to their health and vitality are becoming more relevant. Critical points of viability in the elderly are the moments when their body becomes the most vulnerable and requires special attention and care.

AIM: The study of critical points of viability in elderly patients with visual impairment and the identification of the relationship between various mental or psychiatric diseases.

MATERIALS AND METHODS: A correlation analysis of key variables was carried out and the relationship between different variables was revealed. We conducted several tests to identify cognitive impairment, depression and learned about the quality of people’s sleep.

RESULTS: As a result of the study, 2,646 elderly people underwent 40.5% of men and 59.5% of women, whose average age was 69.69±6.22 years. More than half of the respondents had no physical activity and had a normal sleep quality. According to the study, psychological stability was positively associated with quality of life and negatively associated with depression and sleep quality (p <0.01). Depression, cognitive impairment, and sleep quality were positively associated with quality of life. Sleep quality showed a negative association with quality of life, depression (p <0.01) and cognitive impairment, and a positive association with depression (p <0.01).

CONCLUSIONS: Critical points of viability in the elderly are an important problem that requires special attention and care. Support from relatives, friends and specialists plays a special role, which can help prevent crisis situations and ensure that older people age with dignity. Preventive measures, proper nutrition, physical activity and regular medical examinations also play an important role in maintaining the vitality and quality of life of the elderly.

Acute cerebrovascular accident (CVD) is accompanied by a wide range of long-term disabling functional disorders and disability, necessitating an individual approach to the formation of an optimal complex of rehabilitation measures for a disabled person with the consequences of CVD in order to make rational use of resources and improve the effectiveness of rehabilitation.

An analysis of the literature data allowed us to identify factors that complicate the rehabilitation of people with disabilities with the consequences of STROKE and determine their rehabilitation potential: the main one is cognitive status; auxiliary ones are age, level of motor disorders, aphasia (in particular, the ability to understand instructions), and psychoemotional state. These factors (pre-coded into the appropriate ICF categories) were used in the algorithm for assigning a disabled person with the effects of STROKE to a specific rehabilitation group to form a set of rehabilitation measures. Measurement tools for assessing the designated categories and criteria for assigning a disabled person to a rehabilitation group are proposed.

The developed algorithm makes it possible to formulate a realistic rehabilitation goal and form an adequate set of rehabilitation measures to achieve it, corresponding to the capabilities and abilities of a disabled person. It is assumed that people with disabilities who do not have cognitive impairments have a high rehabilitation potential and a favorable rehabilitation prognosis, which makes it possible to set an ambitious rehabilitation goal and use any available rehabilitation methods with a preference for active ones. The worse the cognitive function indicators, the lower the rehabilitation potential of the disabled person is assumed and the more realistic the goal is formulated; at the same time, preference is given to passive rehabilitation methods using methods adapted to the patient’s cognitive abilities and involving the disabled person’s relatives in the rehabilitation process.