Vol 7, No 3 (2017)

Processes essential for hormone-dependent carcinogenesis occur at different developmental stages, even the earliest. Early deviations in the hormone–metabolic status often inversely correlate with the risk of common age-associated noncommunicable diseases, in particular, tumors in hormone-dependent tissues and cardiovascular disorders. Another paradox is the increase in reproductive system tumor incidence at the age associated with lower production of mitogenic hormones. Therefore, one should take into account the production of steroids directly in target tissues and recognize the importance of the progenotoxic effect of estrogens and their derivatives. Another noteworthy aspect is the role of endocrine–genotoxic switchings, which form the so-called basic triad, generated by age-associated endocrine shifts and environmental factors. In addition to the steroid-dependent set of cancer risk factors, attention should be paid to nonsteroid ones (such as those associated with insulin resistance or inflammatory cytokines), since they are tightly connected with the immune system functional state, mild chronic inflammation, obesity phenotype, and pro-/antiinflammatory lipid factor ratio. All these considerations confirm the importance of timely preventive interventions at early and late developmental stages, which are often several decades apart.

This paper analyzes the results of the study of the long-term effect of physical exercising and sports in the age range, including late periods of human ontogeny, from the standpoint of the oxidative stress theory. To study the features of the ontogenetic variability of the functional state of the organism, a comparative study of the indices of the functional state of the organism was carried out under different regimes of motor activity at different age stages of development: in sport veterans who continue active motor activity after the termination of a sports career, in former sportsmen leading a sedentary lifestyle, in individuals engaged in recreational forms of exercise, and in individuals who were never regularly engaged in physical education. The contingent of male subjects of different ages also included former athletes and coaches of national teams for cyclical and game sports that require a predominant endurance. As a result of the study, a model was developed that reflects the features and mechanisms of ontogenetic variability of the functional state of the organism under the influence of different regimes of motor activity.

To maintain physical performance and cognitive functions in the elderly, multimodal training programs (MTP) are used, which are based on physical training, physiotherapy procedures, psychological training, etc. To increase the efficiency of MTP in the elderly, it is suggested to apply a new variant of adaptation to interval normobaric hypoxia, interval hypoxic-hyperoxic training (IHHT). A placebo-controlled clinical trial included 34 patients aged 64–92 years of the day geriatric hospital of the Klagenfurt Clinic (Carinthia, Austria) who were randomized into two groups: experimental (EG), those who received MTP and IHHT, and control (CG), those who passed the course of MTP during the simulation of IHHT procedures. Before and after the rehabilitation course, cognitive functions and exercise endurance of the patients were evaluated using the dementia detection test DemTect, the clock-drawing test, and a 6-minute walk test (6MWT). During the course of IHHT, cognitive capabilities of EG patients significantly improved in comparison with CG patients: the increase in values in the dementia test was +16.7% (in CG +0.39%, p < 0.001), and that in the clock-drawing test was +10.7% (in CG–8%, p = 0.031). The distance covered in the 6-minute test increased in both the groups but significantly more in OG, 24.1% (in CG +10.8%, p = 0.021). Direct significant correlations between increment in exercise tolerance and cognitive tests were revealed. Thus, the inclusion of procedures for adaptation to interval hypoxia-hyperoxia in MTP in the elderly leads to a significant increase in their effectiveness, which is manifested in the improvement of cognitive functions and physical endurance. IHHT procedures are well tolerated and do not cause side effects.

We investigated 103 newly diagnosed stage II–IV cancer patients aged 28–78 years before the beginning of their anticancer therapy. The signs of cachexia syndrome were diagnosed and staged (precachexia or fully-fledged cachexia), including the age-related characteristics of subjects, based on the CASCO criteria (2011). It has been established that cardiovascular disorders with comorbid cancer pathologies were significantly more frequently recorded in patients with signs of cachexia syndrome already at its precachexia stage, while the cumulative index of cardiovascular disorders has been found to increase in cancer patients as cachexia progressed and its severity increased. The level of melatonin excretion evaluated by the excreted amount of 6-sulfatoximelatonin (aMT6s), the mean melatonin metabolite, was observed to decrease significantly in cancer patients as the CS manifestations became more advanced. The least changes in the aMT6s levels were observed in patients aged over 60 years who were included in the precachexia group, which might indicate the heterogeneity of the given sample due to the combined manifestation of geriatric syndromes and cancer pathologies. A false-positive precachexia diagnosis is also possible, especially, in elderly and old patients, due to a combination of polygenic metabolic and age-related changes, which are to meet, in sum, the current criteria for CS. Therefore, it is recommended to determine the melatonin excretion indicator as an additional marker in the diagnosis and differential diagnosis of CS with its progression, in particular, in geriatric patients. A significant correlation has been found between the emergence of cardiac pathology and/or a worsening in its course in cancer patients with cachexia symptoms and reduced aMT6s content.

Results of research of cognitive visual evoked potentials in elderly women with various level of cognitive decline are shown in the article. Both relevance of the early diagnostics of cognitive disorders and expedience of use of methods of functional neurovisualization to reveal higher cortical dysfunctions are also shown. To appraise cognitive functions, we applied an express-method of evaluating of cognitive functions during normal aging. According to results of this test, two groups were created: the first were women without cognitive disorders and the second were women with mild cognitive impairment. The evoked potentials were registered for all participants using a 128-channel GES-300 system. Latency of P300-wave and reaction time were calculated. According to temporary characteristics of a P300-wave, it has been revealed that the group with cognitive decline differed in longer latent period in centro-temporo-parietal area of the left hemisphere, and also longer reaction time. However, latency of P300 in central-parietal areas of the right hemisphere was less than one in persons of the control group. These changes reflect dysfunction of structures of a medial temporal lobe, which is expressed mainly by memory disorders.

We analyzed catamnesis of combatants–pensioners of the Ministry of Internal Affairs (MIA) of Russia dismissed due to the presence of mental disorders impeding further serving. It is shown that, within 3 years after the dismissal, a negative clinical dynamics of mental state with disability and formation of concomitant alcohol dependence are noted among combatants. They have some serious social problems, like divorce, and they are involved in unqualified manual work or do not work at all. This requires some improved approaches in providing them with medical, psychological, and social assistance, with regular observation. It was proposed to organize Mental Health Centers in the departmental regional health units of the Ministry of Internal Affairs of Russia on the basis of existing centers of psychophysiological diagnostics for systemic monitoring of the mental state of combatants with mental disorders and improving the quality of provision of medical assistance.