[The improvement of cognitive rehabilitation of persons of older and senile age]

The article presents results of study of patients of elderly age within the framework of pilot project on the basis of the geriatric department of the State Budget Institution of the Rostov Oblast "The Hospital for War Veterans". The specially questionnaire was developed with participation of the charitable foundation "Memory of Generations" and the public movement "Medics-Volunteers". The social hygienic characteristics of studied contingent was analyzed. The statistical processing of obtained data was carried out considering subjective status of patients.

[The elaboration of approaches to medical rehabilitation of participants in warfare]

The article considers social hygienic characteristics of participants in warfare underwent treatment and rehabilitation in specialized medical organization. It is established that patients of neurological profile and with diseases of cardiovascular system predominated in the studied contingent. The high need for medical rehabilitation was determined according results of examination of participants in warfare by multidisciplinary rehabilitation team. The necessity of observance staging and continuity in carrying out rehabilitation measures at all levels is emphasized.

[The repeated disability because of thyroid cancer in adult population]

The article presents the results of analysis of repeated disability because of thyroid cancer in adult population of Moscow in 2015-2019. The study established negative dynamics of increasing of the number of individuals with repeated disability because of thyroid cancer in all essential age contingents (young, middle and elderly age) of adult population. The similar trend was revealed in gender contingents of individuals with repeated disability because of thyroid cancer (in males, increase was made up to 112.5% and in females up to 196.3%). In the gender and age structure of repeated disability because of thyroid cancer, predominated females and the elderly. The study established dynamics of decreasing of percentage of individuals with repeated disability because of thyroid cancer of the disability groups I and III and corresponding increasing in disability group II. The percentage of individuals with repeated disability because of thyroid cancer in disability groups I and II was higher in males as compared with females. Most individuals with disabilities because of thyroid cancer don't work. The study results make available spectrum of disorders of main functions of organism, their degree and types and intensity of limitations in vital activity of individuals with repeated disability because of thyroid cancer. The organized database of characteristics of repeated disability because of thyroid cancer in adult population can be used in implementation of personalized approach to medical social rehabilitation of increasing number of disabled individuals with malignant damage of the most important organ of endocrine system.

[Regional aspects of disability due to malignant neoplasms in the Russian Federation.]

The increase in the number of older people (elderly and senile) among the population around the world is associated with a significant impact on the increase in the incidence of malignant neoplasms (MN). The federal project «Fight against oncological diseases for 2018-2024» has been launched in Russia within the framework of the national project «Healthcare». The article presents the results of a study of the general disability (primary and repeated) of the adult population due to MN in the Chechen Republic (2010-2020). The main trends in the dynamics of general disability (age differentiation, severity, level) in the Chechen Republic and in the North Caucasus Federal District as a whole are compared. Older people with disabilities prevail in the structure of both primary and repeated disability due to MN in the Chechen Republic. This corresponds to the indicators for the North Caucasus Federal District and correspond to the data for the Russian Federation as a whole. The level of disability in the Chechen Republic is lower compared to the indicators for the North Caucasus Federal District. The proportion of disabled people with severe group II and group I disabilities is higher in the republic compared to extensive indicators for the district. The formed structure of disability and the identified trends in its dynamics are a scientific and practical basis that is advisable to use when developing an integrated approach to the medical and social rehabilitation of disabled people and the prevention of health disorders due to MN, taking into account the identified features of disability of the population in the territorial subject of the Russian Federation.

[The particular medical social problems of individuals of elderly and senile age as exemplified by the Rostov Oblast]

The article analyzes dynamics of main indices of disability in population older than able-bodied age in the Rostov Oblast. The trend of decreasing of scope of examinations of individuals of the mentioned age group, including decreasing the number of first and iteratively recognized as the disabled, against the background of increasing in the population structure of percentage of individuals older than able-bodied age. At the same time, increasing of accumulated disability was established in the studied category of population.

[The age gender structure of the disabled due to cerebral vascular diseases in Moscow in 2014-2018]

The article presents the dynamics of disability due to cerebrovascular diseases in 2014-2018 in Moscow. The age gender analysis of the disabled in this category was carried out. It was established that 30% of total population of the disabled due to cerebrovascular diseases accounted for the share of those who were recognized as disabled for the first time in the structure of total population. The most frequently disabled persons are those who are older than able-bodied age. In total structure of the disabled due to cerebrovascular diseases, women predominate.

[Analysis of disability among the elderly and senile on the example of the Rostov region.]

The article analyzes the dynamics of the main indicators of disability among people older than working age in the Rostov region. The trend decline in surveys of persons in this age group, including reducing the number of first and repeatedly recognized as disabled, on the background of growth in the region's population share of persons above working age. At the same time, there was an increase in accumulated disability.

[Some aspects of improving the medical and social rehabilitation of the elderly who permanently live in general-type boarding schools.]

The article reflects the age and gender structure of the contingent of elderly people living in a General boarding house. The most common diseases in this category of persons, the presence of a disability group and individual programs for rehabilitation (habilitation) of the disabled person were established. The need for medical care, including medicines, was studied. There is a need to improve measures for medical and social rehabilitation, including in improving the employment of this contingent of people and the development of their leisure time. Examples of positive experience in this area among other regions of the Russian Federation are given.

[The problematic issues of personnel to ensure the delivery of geriatric care.]

The article reflects the problems of personnel provision of geriatric care. this reflects a serious concern about the staffing of the geriatric service. The need to improve the system of training geriatric doctors, including the need to popularize this specialty among medical personnel and the population, is pointed out.

[Some problems of creating a geriatric service in the regions.]

The article reflects the current state of geriatric care in the Russian Federation at the stage of formation of a three-level model of geriatric service. The problems in the organization of geriatric services at the regional level, including the problem of training the appropriate profile, the negative attitude of the elderly to geriatric departments and geriatrics in General. Measures to improve the work in this direction are proposed.

[Disability due to arterial hypertension and alimentary factors, determining cardiovascular risk]

The problem of disability is associated with the problem of socially significant diseases, the main feature and at the same time the key characteristic of which is mass character. The epidemic nature of the spread and the medical and social burden of arterial hypertension (AH) leads to the assignment of this pathology to the number of socially significant diseases. The aim of the study was to analyze primary disability due to AH in Moscow and clinical and pathogenetic parallels between the level of arterial pressure and alimentary factors determining cardiovascular risk (CVR). Material and methods. The object of study was the data on the primary disability of the population of Moscow during the period 2011-2017 according to the form of state statistical observation #7-sobes and data of the Ministry of Health of Russia. The study was retrospective. The subject of a selective study was an analysis of the nosological spectrum of causes of disability, the nature of functional impairment and the degree of disability of elderly people who underwent inpatient treatment at the hospital for war veterans of the Rostov region in 2018-2019. The analysis of the spectrum of factors that determine the CVR. Results and discussion. The total number of newly recognized disabled (NRD) due to hypertension amounted to 11,069 people. The growth of the share of NRD of young age (6.8-11.7%), a decrease in the proportion of NRD of middle age (45.3-41.7%) and elderly in 2015-2016 (39.1-39.9%), but the growth of this indicator in this contingent in 2017 to 46.6% were noted. The proportion of NRD group III increased (to 69.1%), NRD group II decreased (to 20.3%) with a negative trend of growth in the proportion of VPI of the most severe group I. Selective survey data among people with disabilities undergoing inpatient treatment at the hospital for war veterans of the Rostov Region (2018-2019) indicated that they had a wide range of factors determining the CVR. Conclusion. The persistence of patients with hypertension triggers, supporting its further progression, is the cause of the low effectiveness of therapy and exacerbates the prognosis. It is advisable to have a unified approach to improving the efficiency of dietary use at the stages of complex treatment, prophylactic and rehabilitation programs with the goal of primary and secondary prevention of hypertension and disability due to this socially significant pathology.

[The Medical Social Aspects of Repeated Disability of Adult Population Due to Malignant Neoplasms in the Russian Federation]

The article presents the results of the analysis of the level and severity of repeated disability of the adult population due to malignant neoplasms in the Russian Federation. This pathology is associated with high prevalence and mortality, which makes it classify as socially significant. An effective solution to the problem of preventing the debilitating complications of malignant tumors requires the formation of a statistical database to evaluate the results of diagnostic and treatment-and-prophylactic measures and the development of optimal approaches to the medical and social rehabilitation of patients. The authors present the results of the study, which indicate that there is an age-related differentiation of adult disability due to malignant neoplasms -- elderly people predominate. In middle age, the level of recurrent disability due to this class of diseases decreases during the analyzed period (2008-2017). Among the population of young age, the tendency to change the level of recurrent disability is less stable, however, since 2014, there has been a trend for the growth rate. The structure of recurrent disability by severity is characterized by the predominance of persons with disabilities II (43.6%) and III (42.1%) disability groups with a lower proportion of persons with disabilities with I first disability group against the background of a uniform trend of increasing disability level of all three groups. The results of the ranking of subjects of the country by the level of re-disability due to malignant neoplasms among the adult population are presented. The selected subjects of the Russian Federation with a negative situation, which makes it possible to substantiate the need to strengthen measures for the prevention of primary disability and optimize the medical and social rehabilitation of patients suffering from this disabling pathology, taking into account regional features.

[Some aspects of rehabilitation of disabled persons of the elderly and senior age at the present stage.]

The article presents the results of the analysis of the needs of elderly and elderly disabled in various types of rehabilitation, including providing them with technical means of rehabilitation, reflects the problems that this group of people have when it comes to resolving issues of medical and social rehabilitation. The importance of an integrated approach in carrying out rehabilitation measures in the study contingent was stressed. Attention is focused on some imperfection of the current regulatory and legal framework in the part concerning the examination in the service of medical and social expertise of the disabled elderly and senile. It is proposed to make appropriate changes that provide for a simplified, in-absent examination of this contingent of persons in the service of medical and social expertise, if it is necessary to make or introduce changes to the current individual rehabilitation program, to habilitate.

[Medical and social problems of seniors at the present stage.]

The article presents the results of the analysis of the needs of long-lived people with disabilities in medical and social care, reflects the problems that arise in this contingent of persons when it is necessary to address the issues of medical and social rehabilitation. A medical and social examination of 238 long-lived patients undergoing inpatient treatment in a geriatric medical organization was carried out. The most frequent deviations from the norm in laboratory and instrumental methods of research are revealed. Screening of «Age is no obstacle», which revealed the presence of cognitive disorders and depression in a significant number of investigated and their dependence on others. Emphasized the importance of participation of bodies of social protection of the population in solving the problems of the aged.

[Effect of anthropo-technogenic load on medico-social aspects of primary morbidity and disability of population.]

Population aging is a global social phenomenon that affects the most important health indicators of the population. The older generation is particularly vulnerable in the current conditions of urbanization and the associated environmental situation. The comprehension of indicators of disability and morbidity of the population, the study of the factors that determine the negative processes of health damage, taking into account regional features of these processes are necessary for the planning of preventive measures. In the age structure of the primary disability of the adult population in the Voronezh region elderly disabled people make up 53,3%, middle and young people with disabilities are less - 30,1 and 16,6%, respectively. These indicators are higher than the average Russian. The results of non-carcinogenic risk and primary morbidity analysis in population of Levoberezhniy district of Voronezh under permanent anthropotechnogenic load have presented. It has been established that non-carcinogenic risk coefficients were bigger that acceptable level (HQ>1) by for nitrogen dioxide, acrylonitrile, acrolein, 1,3-butadiene, copper oxide, chromium+6. Unacceptable level of non-carcinogenic risk is typical for respiratory organs pathology, pathologies of cardiovascular system and endocrine system. Analysis of the primary morbidity of these nosological forms shows their high distribution in adult population morbidity. Under rehabilitation measures in patients with respiratory organs diseases, circulatory system and endocrine system diseases it is necessary to consider anthropotechnogenic load and relationship between agents and disease development.