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Summary:
acute respiratory diseases or, as it is customary to name them, acute respiratory infections (Ori) is an urgent problem of modern medicine, especially during periods of sharp fluctuations in the temperature and humidity of the environment, when the traditionally expected incidence of influenza and other visual or mixtures increases sharply .

By the beginning of 2013, the share of people aged 65 and older amounted to an average of about 13%in Russia, and in some regions - 28%. It is predicted that in the global structure of the population by 2050 it will be 22%. In Russia, by the beginning of 2021, an increase in the number of people aged 65 years and older to 22.9 million people, 80 years and older - 5.5 million people are expected; 100 years and older - 7266 people. The fastest growing group of population in economically developed countries is 80 years of age and older.
The data of evidence -based medicine on the effectiveness and safety of drugs (drugs) in the elderly are extremely limited, since the age> 65 years remains one of the main criteria for non -inclusion in randomized controlled studies (RCTs).
Meanwhile, the effectiveness and safety of therapy in elderly patients can differ significantly from those in middle and young people, which is associated with age -related changes in physiology, leading to changes in pharmacokinetics and pharmacodynamics of many drugs.
Other factors that complicate pharmacotherapy in elderly people include: “fragility” (frailty), somatic and mental comorbidity and polypragmasia associated with it, social factors (loneliness, helplessness, poverty), low learning and low commitment to treatment.

Target. To study the cognitive status in elderly patients with arterial hypertension observed in clinical conditions.

Material and methods. The study included 356 patients; The average age is 74.9 ± 6.1 years, 80.4% of them are women. To evaluate cognitive functions before and after treatment, neuropsychological testing using MMSE - a brief scale for assessing mental status was performed; watch drawing test; The test of literal and categorical associations.

Results. In the group of patients <80 years, the severity of cognitive disorders by MMSE correlated with blood pressure (blood pressure): for systolic blood pressure (r = -0.22, p = 0.0003), for diastolic blood pressure (R = -0,13, p = 0.03), i.e. In patients with higher blood pressure, low points were noted on the scale of assessing the cognitive status based on the results of the correlation analysis of Spearman. While in group ≥80, both correlations were insignificant, for systolic blood pressure (r = -0.05, p = 0.64), for diastolic blood pressure (r = -0.13, p = 0.25).

Conclusion. Patients of elderly and senile ages with arterial hypertension should have a differentiated approach to the level of blood pressure depending on age and the presence of cognitive disorders, an integrated approach to therapy in these patients can prevent further progression of cognitive status worsening.

Key words: arterial hypertension, cognitive impairment, dementia, elderly.

Target. To study the factors that determine the commitment of optimal therapy of elderly patients with chronic heart failure (COM) observed on an outpatient basis.

Material and methods. In an open, comparative simultaneous, incomplete study, 80 patients with heart failure at the age of ≥60 years were included. The comparison group consisted of 40 patients (18 men and 22 women) with diseases of the cardiovascular system without heart failure. Patients were evaluated by the Comorbidity index, laboratory and echocardiographic parameters, a 6-minute walk test, cognitive status, adherence to treatment, and a two-photon X-ray absorption was carried out. The criteria of senile asthenia was considered the presence of 3 signs according to the Frail scale (Fatigue, Resistance, Ambulation, Illnesses, Loss of Weight).

Results. The committed treatment was 40% of patients with heart failure and 75% - comparison groups (p <0.001). In a single-factor analysis, a relationship of adherence to treatment with the level of cognitive status by the Mini-Mental State Examination questionnaire is established-the ratio of chance (OS) 1.5; 95% confidential interval (DI) 1.2-1.9 (p <0.001), senile asthenia-Osh 3.5; 95% DI 1.3-9.5 (p = 0.011), osteoporosis-Osh 2.98; 95% DI 1.0-8.9 (p = 0.050), Cherlson coomorbitability-Osh 1.21; 95% DI 1.0-1.5 (p = 0.050).

Conclusion. 40% of outpatient patients with heart failure at the age of ≥60 years were committed to treatment. Multiple concomitant pathology, impaired cognitive status, osteoporosis, senile asthenia have a negative effect on commitment to the treatment of older people with heart failure.

Key words: commitment to treatment, elderly age, heart failure, senile asthenia, osteoporosis.

Metabolic syndrome (MS) is a factor in the risk of acute and chronic vascular diseases of the brain. Oxidizing stress developing under these conditions contributes to the progression of atherosclerotic lesions of the brachiocephalous arteries, which makes it necessary to correct the identified pathobiochemical disorders. The use of antioxidant drugs in patients with cerebrovascular diseases and MS helps to reduce such manifestations of the latter as insulin resistance, hyperthyglyceridemia, hyperglycemia. The article presents the results of studies of Mexidol in patients with chronic cerebrovascular diseases against the background of atherosclerosis and MS, demonstrating good prospects for the use of drug compounds of this group with the aim of comprehensive correction of various links in the pathogenesis of developing pathology.

A high level of glucose in the blood with a hypoxic-ischemic state is one of the main factors that determine the degree of brain damage. The consequence of a hyperglycemic-ischemic state is an increase in the formation of active forms of oxygen and impaired functioning of the endogenous antioxidant system. To compensate for the forming cerebrovascular disorders against the background of a combination of ischemia and diabetes, drug treatment must be used. The most effective tools are antioxidants from the group of
2-ethyl-6-methyl-3-oxypyrididine derivatives.
Key words: brain ischemia, phospholipids, phosphatidylcholine, diabetes mellitus, neuropathy, free radicals.

Summary:
the prevalence of diabetes (diabetes) of the 2nd type and metabolic disorders preceding it reached the scale of the epidemic. Oxidative stress plays a significant role in the development of micro- and macro-vascular complications in patients with diabetes. The accumulation of free radicals is responsible for the activation of pathological biochemical ways responsible for the development of systemic and vascular inflammation, endothelial dysfunction, hypercoagulation and ischemic conditions. Since damage to the vascular and nervous systems is not leveled even with adequate control of glycemia, comprehensive pathogenetic treatment strategies are needed. One of the mandatory components of the complex therapy of complications of diabetes is the use of antioxidant therapy using the drug Mexidol.