Clinical-functional features and problems of rehabilitation in patients with osteoporosis of the elderly age in combination with accompanying pathology
Authors:   Saint Petersburg Institute for Advanced Training of Medical Experts, Saint Petersburg, Russia, Dymnova Svetlana E. , Dymnova Svetlana E. ,   Hospital for Veterans of Wars, Saint Petersburg, Russiа, Sergeeva Vera V. ,   Saint Petersburg Institute for Advanced Training of Medical Experts, Saint Petersburg, Russia
Published: February 2021

Osteoporosis is one of the most common metabolic diseases of the skeleton that develops with age. Close attention to osteoporosis is explained by its high pre-valence, as well as often severe medical, social and economic consequences, in the form of fractures of the vertebrae and peripheral bones, which lead not only to disability, but also high mortality, especially among elderly patients. To date, there is no unified and clear method of treatment and rehabilitation of patients of older age groups, taking into account their clinical and functional characteristics against the background of concomitant diseases. As a result, many patients do not receive the treatment they need, or the effect of treatment is often lower than expected. Aim. To analyse of clinical and functional characteristics, quality of life and the main directions of rehabilitation of elderly patients with osteoporosis in combination with concomitant pathology in the form of impaired carbohydrate metabolism. Materials and methods. The study included 188 elderly patients diagnosed with osteoporosis. The control methods were general clinical examination, ECG and 24-hour ECG monitoring, ECHO CG, analysis of BMD using dual-energy X-ray absorptiometry – densitometry (dualenergy X-ray absorbtiometry – DXA). Assessment of the degree of development of the atherosclerotic process by ultrasonic duplex scanning (USDS). In order to determine the structural and functional state of the abdominal organs, all patients underwent ultrasound examination. All patients were examined by related specialists: an ophthalmologist, neurologist, cardiologist. To diagnose diabetic neuropathy, the following diagnostic scales were used: the Neuropathy Symptom Score (NSS). The quality of life (QOL) of pa-tients was assessed using the MOS SF-36 questionnaire (modified version for Russia). Results. The features of the clinical picture of osteoporosis, complicated and not complicated by pathological fractures of various localization, are highlighted, taking into account the age characteristics of patients and the influence of concomitant pathology. Difficulties in the treatment and rehabilitation of patients with osteoprosis and its consequences, accompanied by limitation of physical activity, pain syndrome, psychoemotional disorders, resulting in a decrease in the quality of life, are described. Conclusion. Modern methods of treatment and rehabilitation provide great opportunities for restoring working capacity and significantly improving the quality of life in patients with osteoporosis and its consequences. However, existing programs of treatment and rehabilitation should be developed individually, taking into account age, severity of structural and functional disorders, as well as the presence and severity of concomitant diseases.