Features of response to the stress of elderly men and women with chronic brain ischemia

Authors:
Slyusar T.A., Abramenko Yu.V., Rubin S.S., Mayorov R.V., Slyusar I.N.

FSBEI in the Tver State Medical University of the Ministry of Health of Russia, Tver

Place of publication:
MEDICAL ALPHABET No. 22 / 2021. NEUROLOGY AND PSYCHIATRY (3)

Abstract:
Objective of the study. To study the characteristics of stress response, stress resistance and adaptation in elderly men and women with chronic cerebral ischemia (CCI), as well as the stress-protective effect of Mexidol. Materials and methods. The study included 124 patients aged 60–74 years: 72 men and 52 women (mean age 65.3 ± 0.4 and 64.7 ± 0.7 years, respectively) with CCI stages I–II against the background of arterial hypertension and its combination with cerebral atherosclerosis. The level of psychosocial stress was determined using the Holmes-Ray scale. The characteristics of patients' response to stress were studied using the PSM-25 Psychological Stress Scale and S. Rosenzweig methods. Stress resistance was studied using the stress resistance self-assessment test by S. Cohen and G. Villianson. Anxiety levels were assessed using the C. D. Spielberger and Yu. L. Khanin Anxiety Scale, and depression was assessed using the Beck Depression Inventory. The type of adaptive response was assessed using the white blood cell count (WBC) based on the percentage of lymphocytes and segmented neutrophils, taking into account the representation of other formed elements. Results. Elderly women with CCI had higher stress levels than men. Men exhibited a predominance of intropunitive stress responses and a resolving response, while women exhibited a predominance of extrapunitive stress responses and a self-protective response, indicating greater frustration in women. Women had lower levels of stress tolerance than men and correlated with higher levels of situational anxiety. Adverse adaptive responses were more common in women. A course of Mexidol treatment in elderly patients with chronic cerebral ischemia resulted in a reduction in the severity of subjective and objective symptoms and anxiety disorders, and increased stress resistance and adaptive capacity, as evidenced by an increase in the number of individuals with favorable adaptive responses. Sequential Mexidol therapy (injections followed by Mexidol Forte 250 tablets) was shown to be highly effective and safe. Keywords: chronic cerebral ischemia, gender, stress, stress resistance, emotional disorders, anxiety, depression, Mexidol, adaptive responses.