According to the classification of the Regional Office for Europe, old age for men is considered to be the period from 60 to 74 years, for women - from 55 to 74 years. With the 75th anniversary comes old age (old age). The period after 90 years is called longevity (eldership).

The process of human aging is not only a physiological, but also a psychological and social phenomenon. It is not surprising that the psychology of older people usually has its own characteristics, because during this period the whole life undergoes serious changes.

Old age is characterized by a decline in vital activity. As a rule, a person identifies himself as elderly. There is no clear age limit for the onset of old age. They are determined by the individual. But in general, for example, 70 years is quite possible to say about the onset of old age. A fruitful and joyful old age is associated with the adoption of one's life path. If a person does not accept such an inevitable course of events, then a crisis of old age awaits him.

Two sides of the aging process

The aging process occurs in two interdependent directions: psychological and physiological.

Changing the human psyche, his character and behavior. A person becomes more irritable, inattentive, tired, sharply opposite emotional moods arise. Memory impairment and insomnia are also noted. Old people despair at the sight of an aged body. In extreme old age, thoughts about imminent death increasingly arise. At the stage of aging, a person, as it were, sums up the results of his life activity. Absolutely all older people feel that their life has flown by instantly. And that if they were given a second opportunity, they would do a lot in this way, correcting the mistakes of life. With age, a person withdraws more and more into himself, becoming closed from everyone, even those closest to him.

Changes at the physiological level are more noticeable to others than mental ones. This changes the structure of the skin, hair, nails. The number of new cells in the skin decreases, while the content of dead cells increases. The elasticity of the skin deteriorates, it darkens, folds form - wrinkles. Hair also experiences this process, they become dull, brittle, gray. In men, baldness occurs, in women, hair begins to grow less often. This is due to insufficient intake of minerals and vitamins in the body.

In aging people, the figure changes, a person begins to gain weight, or, conversely, lose weight. But more often than not, obesity is a sign of an accelerated aging process. The work of all organs and systems of the body worsens, weakening of the immune system. Because of this, older people are more prone to various kinds of diseases.

However, different people evaluate their aging process differently. Some people begin to think about the fact that they are already aging at the age of 30, and some at 50 try to look young and not pay attention to a few wrinkles that have appeared.

There are different opinions among scientists about the causes of the aging process. Most, however, lean towards the DNA theory. Its essence is that over time, human DNA is damaged, these damages affect the aging process. DNA degrades over time and cannot carry the correct information about a person, and a person begins to age.

Problems of old age

After 55-60 years there is a significant decrease in the physical strength of a person, his health worsens, and his vital energy decreases. At the same time, destructive processes cover almost all functions of the body:

• the work of the sense organs worsens;
• the reaction rate slows down;
• reduced mental activity and ability to memorize.
• All this invariably entails a deterioration in the psycho-emotional state of a person.

Elderly people constitute a separate social group, which has its own characteristics and needs. Accordingly, the thinking, behavior and habits of these people differ significantly from the standards professed at a younger age. Despite the general age features, it is customary to distinguish several types of old age:

• psychological: loss of interest in the outside world, inability to adapt, unwillingness to acquire more new knowledge;
• social: retirement and narrowing of the social circle (often accompanied by a feeling of own uselessness and worthlessness);
• physical: aging of the body, general weakening of the body and the appearance of diseases.

Advanced age invariably entails changes in social sphere. The position of the elderly person in society is changing, and due to these changes, he has to face many difficulties every day. Around this time, people tend to retire. As a result, this period is often accompanied by psychological problems, because the deterioration in health and financial situation is experienced quite strongly. Such changes are equally difficult for both men and women of advanced age. They have to adapt and get used to the new conditions of life, and despite the fact that the ability to adapt in their years is significantly reduced.

Many people perceive the termination of employment and retirement as a catastrophe. Often, an elderly person associates the loss of a job with their own worthlessness and uselessness, so for him this becomes a serious psychological problem. As a rule, the appearance of a large amount of free time and the need to occupy oneself with something only worsen the situation. In such cases, family support is essential. It is relatives and friends who must demonstrate to an elderly person that he still brings great value, raising grandchildren or doing this or that housework.

Features of the behavior of the elderly

The data of recent gerontological studies indicate that after 65 years of age, as a rule, people's attitude to life changes. They have calmness, caution, prudence and wisdom. The level of self-esteem and the sense of the value of life often increase.

One more characteristic feature aging is a change of priorities. People begin to pay much less attention to their appearance, but more to their internal state and health.

Often the elderly and senile age cause negative changes in a person's character. Most often this happens because the ability to control reactions to external stimuli is significantly weakened. That is why most of the less attractive character traits that before a man managed to hide, with age they come to the surface.

Another feature of the psychology of older people is the frequent manifestation of egocentrism and intolerance towards everyone who does not show proper attention to them.

Old age also has other features, including an exaggerated perception of reality and a peculiar sense of time. The first phenomenon is explained by the scarcity of events in the life of a pensioner, so even a minor incident can fill all his thoughts. He can think about it for a long time and still not always come to the right conclusions. This explains the constant appearance of anxiety, fears, far-fetched problems that have absolutely no reason.

As for the peculiar flow of time, this feature is manifested in the constant presence of the past in the present life. It is the age of the elderly that pushes them to constant attempts to stop time and return to it those moral and spiritual values ​​that were inherent in the period of their youth and health. This explains the love of many old people for memories. At the same time, experts assure that the emotional experiences that are associated with the young years of the elderly are extremely useful for them, as they give vigor and expel apathy.

Mastering new social roles

Old age is characterized by a change in life in all its areas:

• people stop working - retire;
• they cease to be bosses;
• they cease to be children - they bury their parents;
• they cease to be parents - their children get on their feet and start their own families;
• they lose their physical condition - this is also difficult to accept in oneself;
• they change their sex life;
• they stop traveling - there is no strength and desire;
• they resign themselves to the inevitability and proximity of death.

A very unpleasant thing in old age is memory loss, that is, its weakening. To prevent this from happening, scientists recommend moderate exercise. So jogging for 2 km. can preserve memory in old age.

For some time after retirement, a person retains old work contacts, which inevitably weaken over time. Gradually, communication with family and relatives comes to the fore, friends appear among pensioners. The psychological characteristics of old age often imply a rethinking of former attachments and values. An increased psychological defense develops, which, on the one hand, helps to maintain inner peace of mind, and on the other hand, brings the effect of denial, which is expressed in unwillingness to change the way of life or receive new information. Over time, all this can lead to self-isolation of a person.

In this case, the age of an elderly woman is especially important, since the representatives of the beautiful half of humanity are mentally more difficult to endure the aging process. As a rule, the dynamics of mental aging is determined by four groups of reactions:

1. Reaction to diminishing bodily (physical) sensations and the subjectivity of their processing (the body's capabilities decrease, reactions slow down, there is a delay in the reaction to irritation, etc.).
2. Reaction to a change in some mental functions and the subjectivity of their experience. As a rule, the most common problems of the elderly, including the deterioration of short-term memory, the difficulty of perceiving the phenomenon in all its diversity, the rapid depletion of attention, the violation of adaptive capabilities and the speed of mental reactions often lead to a decrease in interests, low self-esteem and a narrowing of the social circle.
3. Reaction to changing social position and connections.
4. Reaction associated with thoughts of imminent death. People are always ambivalent about the fact of the finiteness of life. The characteristics of old age do not influence this perception so much. A person's religious ideas, cultural environment and type of temperament have a much greater influence.

In the process of age-related changes in social reactions, psychologists distinguish a number of stages:

direct or indirect preservation of ties with the main activity (this can be both the performance of episodic work, and the reading of specialized literature, or the writing of scientific papers on professional topics);

narrowing the range of interests: everyday topics prevail in communication - from family events (typically mainly for older women) to discussion of television programs (for men);

taking care of your own health to the fore greater value acquire conversations about medicines and methods of treatment);

the acquisition of a new meaning of life, which consists in the preservation of life itself (the social circle is reduced to family members living together, doctors or social workers);

maintenance of life (communication is almost completely absent).

In some cases, the psychological characteristics of the elderly and senile age can acquire a psychopathological character and proceed in six stages:

becomes more and more important real life rather recurring memories of the past;

memory loss progresses;

reality is constantly moving away and becoming more and more unreal;

confusion and helplessness appear, followed by apathy towards the environment, after which - disorientation in what is happening;

confusion and senile amentia (insensibility of consciousness), which is accompanied by a violation of the control of the sphincters;

complete helplessness.

It should be noted that the psychological characteristics of the elderly are purely individual. As a rule, they are determined by heredity and the onset of old age in the family, the presence of somatic diseases, stress or long-term dissatisfaction with vital needs.

Physical condition and diseases of the elderly

With age, physiological changes occur in the human body, which are primarily expressed in the deterioration of biological functions and a decrease in the ability to adapt to metabolic stress. Often they are accompanied by a change in psychological and behavioral reactions. The biological aspects of aging are complemented by a constant deterioration in general health. As a rule, after the age of 60, the human body is more vulnerable to diseases, many of which arise due to a decrease in the effectiveness of the immune system.

The so-called diseases of old age are a combination of signs of aging and diseases that the immune system can no longer cope with. For example, young people recover from pneumonia quite quickly, while for an elderly person it may well become fatal.

Separately, it is worth noting the decrease in the efficiency of the work of internal organs, including the heart, lungs, kidneys and brain. This phenomenon is partly explained by the loss of cells and a decrease in the possibilities of their restoration. In addition, the cells of older people are not always able to perform their functions efficiently enough.

The most common diseases in the elderly are heart failure, angina pectoris, arterial hypertension, chronic bronchitis, pulmonary edema, kidney failure, chronic pyelonephritis, diabetes and others.

The age limits of old age - from 55/60 (women/men) to 74 years, senile (advanced) age - from 75 to 90 years.

As tasks of development in old age and senile age, we can distinguish:

the need to realize the value of one's personality outside of a professional role;

• - maintenance different types activity (motor, sexual, intellectual, social, creative);
• - transfer of social experience to a new generation;
• - comparison of life plans and their implementation (summarizing life).

Awareness of the value of one's personality outside of a professional role is associated with permission pension crisis.

Ananiev emphasized that the influence of a person's life path during aging is immeasurably greater than in the early years.

In the aging process, a special place is occupied by a gradual, non-frontal, heterochronous deployment involutionary processes. Among them, one can distinguish a decrease in the ability to withstand physical and nervous stress, loss of vitality of body tissues, a decrease in the sensitivity of the sense organs, aging of the cardiovascular, endocrine, immune and other systems.

Along with involutionary processes, changes occur at all levels of human organization that allow preventing or overcoming destructive (destructive) phenomena in the elderly and senile age. The processes of self-organization and self-regulation, which have an individual character, play an important role here.

There is a noticeable strengthening and specialization of the action of the law of heterochrony, as a result of which the work of some body systems is preserved for a longer time and even improves, and in parallel with this, accelerated involution of other systems occurs. At the same time, the role and significance that these systems play in the main, vital processes is very important. The more complex the nervous structure, the more opportunities it has for its preservation.

The same patterns were found in the study of the aging process of perception, thinking, memory: logical memory is best preserved; figurative memory weakens more than semantic.

Based on a number of data and, in particular, on the studies of the English gerontologist D. B. Bromley, Ananiev wrote that in the process of gerontogenesis, the opposite course of development of some verbal (awareness, definition of words) and non-verbal (practical intelligence) functions is especially noteworthy. The decrease in non-verbal functions becomes pronounced by the age of 40. Meanwhile, it is from this period that verbal functions progress most intensively, reaching the highest level after 40-45 years. There is no doubt that speech-thinking, secondary signal functions resist the general process of aging and themselves undergo involutional shifts much later than all other psychophysiological functions.

In other words, for safety and further development Mental functions in the period of aging are significantly influenced by professional activity and education. With a high level of education, there is no decline in verbal functions until old age. The level of education is closely related to the speed of speech, erudition and logical thinking. Elderly people are also characterized by a high preservation of those functions that were actively included in professional activities.

Maintaining various types of activity acts as a factor of longevity, including psychological.

The attitude of society towards people of the elderly and senile (advanced) age is often due to "ageism"- a negative stereotype of the perception of an elderly person (weak, feeble-minded, "burden", etc.), which creates certain fears in anticipation of this age.

In the theory and methodology of physical culture, the features of physical exercises with persons of elderly and senile (advanced) age are presented. AFK has great potential in this perspective. Great popularity as a modern type of physical activity for people of this age has gained Scandinavian (northern) walking.

In the process of physical culture and sports, it is necessary to take into account the following age-related psychological characteristics of elderly and senile (old) people:

• it is necessary to apply general psychological rules of communication (listen carefully, formulate questions correctly, etc.);
• calmly repeatedly (repeatedly) explain and demonstrate the technique of performing a motor action;
• celebrate successes, at the end of the lesson, express confidence in the next meeting (an involuntary obligation for a person);
• if possible, clarify which address the trainee prefers (by first name, patronymic, first name, first name with the prefix "aunt" /
• do not be offended if they turn to the instructor on the “you”.

• See: Rybalko E.F., Golovoi L.A. Gerontogenesis // Psychology: textbook / ed.A. A. Krylova. M., 1998.
• See: Craig G. Developmental Psychology. SPb., 2001.

The number of older people in the world is constantly growing. There is a steady aging of the population of our planet. The proportion of people over 65 in society is growing, especially in Western countries. For example, in the United States, the highest population growth rates are observed for the population aged 85 years and older.

The aging of the population as one of the main demographic phenomena in developed countries is expressed in the age structure of the population. The share of groups of people over 60-65 years old is 11.8-21.9% of the total population in countries such as the USA, Great Britain, Russia. At the same time, a tendency towards an increase in the proportion of older people in the demographic structure of society is becoming more and more pronounced. In the population of, for example, Great Britain for the period from 1935 to 2035. the number of persons over 60 years of age will increase from 12.5% ​​to 23.4%, while the proportion of persons from birth to 19 years of age, on the contrary, will decrease from 30.7% to 22.4%.

According to the International Classification, three gradations of the period of gerontogenesis are distinguished:

• Old age for men 60-74 years old, for women - 55-74 years old,
• Senile age - 75-90 years,
• Long-livers - 90 years and older.

The identification of the aging period and the development of the problems of gerontogenesis are associated with a complex of socio-economic, biological and psychological reasons, with the increasing role of the human factor in the development of society. The processes of population aging have already had a serious impact on all healthcare institutions and aspects such as urgent care, help with chronic diseases and conditions requiring long-term treatment.

Old age is a hereditarily programmed phenomenon. Physiological old age is not complicated by any pathological process, it is the old age of practically healthy elderly and old people.

Premature aging can be observed under the influence of a complex of unfavorable factors, such as excessive long-term psycho-emotional overload, significant restrictions on physical activity, and environmental hazards. Pathological, premature old age is complicated by diseases. Factors that accelerate aging include smoking, alcohol abuse, drug use. Persons suffering from obesity, endocrine disorders, some other diseases accompanied by circulatory and respiratory disorders, and chronic intoxication of the body age early.

In the elderly and senile age, the frequency of diseases of the internal organs is extremely high. More than 90% of people of this age period suffer from them. A third of all visits to doctors by older people is associated with diseases of the cardiovascular system, the incidence of the digestive system, respiratory, kidney and urinary system, and oncological processes is high.

Improper nutrition is a common cause of the development of disorders in the activity of many organs and systems in the elderly, especially when an acute illness occurs against the background of an already existing chronic disease or some kind of disorder. Improper nutrition most adversely affects the body of an elderly person.

Even with physiological old age, there are shifts in metabolism and the state of organs and systems of the body. The main problem in elderly people with some kind of disease is protein-energy malnutrition (PENP) in combination with micronutrient deficiencies. Severe BENP has been found in 10% to 38% of elderly outpatients, 5% to 12% of those at home, 26% to 65% of hospitalized elderly, and 5% to 85% of those admitted to nursing homes. In 1977, data were published that 4% of older people in the UK suffer from malnutrition.

On the other hand, numerous studies show that many older people who do not have protein-energy malnutrition also eat improperly. The number of overweight people is growing. Obesity is a serious risk factor for the progression of atherosclerosis, hypertension, cholecystitis and gallstone disease, diabetes mellitus, gout and uric acid diathesis, arthrosis and other changes in the musculoskeletal system. Currently, the diet of many older people is dominated by food containing fats of animal origin. Meat is consumed in much greater quantities than fish. The excesses of flour and sweet products are obvious. At the same time, vegetables, fruits, herbs, vegetable oil are supplied in limited quantities.

By changing the nature of nutrition, it is possible to influence the metabolism and the adaptive-compensatory capabilities of the body and influence the pace and direction of the aging process. The development of scientifically based recommendations on rational nutrition in old age, the observance of which is an important factor in the prevention of pathological layers on the physiologically natural aging of the body, is an important section of dietetics - gerodietetics.

Malnutrition in the elderly

The relationship between body mass index (BMI) and mortality rate was revealed. In the early period of a person's life, the greatest risk is being overweight. In the future, with each passing decade, the relationship between nutritional deficiencies (low BMI) and mortality increases.

There are many factors that influence the nutritional status of elderly and geriatric patients. In the form of such factors, socio-economic conditions of life, and the physiological characteristics of the digestive organs of older people, and the psycho-emotional state of people are considered.

• Mnemonic scheme of causes of weight loss "MEALS-on-WHEELS" (Miller et al., 1991).
  • Taking certain medications.
  • Social problems.
  • Emotional (depression) disorders.
  • Lack of money (poverty).
  • Vagrancy (dementia).
  • Anorexia senile.
  • Elderly abuse.
  • Senile paranoia.
  • Eating disorders (inability to eat independently).
  • Oral factors.
  • Swallowing disorders (dysphagia).
  • Intestinal disorders (malabsorption).
  • Stones in the biliary system.
  • Hyperthyroidism, hyperparathyroidism, adrenal insufficiency.
  • Low salt, low cholesterol diet.

• Definition of malnutrition in the elderly

  Early detection of malnutrition allows timely nutritional support. Screening for malnutrition can be done on an outpatient basis, in a hospital, in elderly people attached to different institutions.

  Nutrition mini-questionnaire (part 1).

  
  

  A. Has the patient eaten less in the last 3 months due to loss of appetite, indigestion, chewing or swallowing 0 = complete loss of appetite 1 = decreased appetite 2 = appetite saved

  B. Has there been any weight loss in recent months 0 = lost more than 3 kg 1 = don't know 2 = lost 1-3 kg 3 = did not lose weight

  B. Patient mobility 0 = only within the bed or chair 1 = Can get out of bed or chair, but does not leave the house 2 = leaves the house

  D. Has the patient suffered from any medical conditions in the past 3 months 0 = yes 2 = no

  E. Neurological disorders 0 = severe dementia or depression 1 = moderate dementia 2 = no

  E. Body mass index (BMI) 0 = BMI less than 19 1 = BMI = 19 2 = BMI 21 to 23 3 = BMI over 23

  Total (maximum 14 points): 12 points or more - normal, no risk of eating disorders, do not fill out the second part 11 points or less - possible presence of eating disorders, continue to complete the questionnaire

  In the first part of the nutrition mini-questionnaire, it is possible to score from 0 to 14 points. The questionnaire contains 6 items related to general behavior, subjective factors, weight and height. In patients at high risk (score 11 or lower), a nutritional assessment may also be performed to determine the degree of malnutrition and the most appropriate nutritional plan.

  The best way assessment of nutritional status is presented in the second part of the nutritional mini-questionnaire, which was developed in collaboration with the University of Toulouse, New Mexico Medical School and Nestlé Research Center (Switzerland).

  Nutrition mini-questionnaire (part 2).

  G. Can the patient live independently (not in a nursing home or hospital) 0 = no 1 = yes

  H. Takes more than 3 prescription drugs per day 0 = yes 1 = no

  I. Are there pressure sores or skin ulcers 0 = yes 1 = no

  K. How many times a day the patient eats 0 \u003d 1 time 1 = 2 times 2 = 3 times

  K. Consumption of protein-rich foods At least one serving of dairy products (milk, cheese, yogurt) per day (yes? no?) Two or more servings of legumes or eggs per week (yes? no?) Meat, fish, poultry daily (yes? no?) 0.0 = if 0 or 1 "yes" 0.5 = if 2 is "yes" 1.0 = if 3 is "yes"

  M. Consumes two or more servings of vegetables per day 0 = no 1 = yes

  H. How much liquid (water, juice, coffee, tea, milk…) do you consume per day 0.0 = less than 3 cups 0.5 = 3-5 cups 1.0 = over 5 cups

  A. How does the patient eat? 0 = unable to eat unaided 1 = eats by himself, but with difficulty 2 = eats by himself

  P. How the patient himself assesses his nutrition 0 = believes that he eats poorly 1 = don't know 2 = thinks he has no eating problems

  P. How the patient assesses their health compared to peers 0.0 = not as good as peers 0.5 = don't know 1.0 = good 2.0 = better than peers

  C. Mid-shoulder circumference in cm 0.0 = less than 21 cm 0.5 = 21 to 22 cm 1.0 = 22 cm or more

  T. Calf circumference in cm 0 = less than 31 cm 1 = 33 cm or more

  Total (maximum 30 points): 17-23.5 points - the patient is at risk for the development of malnutrition; less than 17 points - the patient has obvious malnutrition

  The scale contains 12 items covering anthropometric measurements, dietary behavior, general and subjective factors. Filling out the questionnaire takes 10-15 minutes, the number of points scored is from 0 to 30. 24-30 points correspond to a good nutritional status, 17-23.5 - "risk of development" of malnutrition, less than 17 points indicate protein-energy malnutrition.

  
  

  Cognitive functions can be assessed using the developed special questionnaires. Moods can also be measured using effective questionnaires, such as a mood profile assessment, to determine if a patient is depressed.

  Functional measurements such as hand dynamometry, FEV1 (forced expiratory volume in the first second) or peak expiratory volume flow are used for physiological assessment of other age groups, but in very old people it is very difficult to evaluate their results.

• Features of physiology in old age
  • Digestive system in aging

    Physiological aging of the body is accompanied by a serious functional and organic restructuring of the organs of the digestive system. This process is called "involution" and begins long before the onset of a person's biological old age. Already at the age of 40–50 years, the digestive organs undergo functional changes, which allows the gastrointestinal tract to adapt to the changing conditions of life and activity of the body. Subsequently, functional changes acquire an irreversible organic character.

    Changes in the work of the digestive organs in elderly and senile people, as a rule, are slowly developing in nature, occur individually at different periods of life. The rate of development of involutionary processes depends on the lifestyle of a person at a young and middle age. The most important condition for preventing early aging of the body is proper nutrition (both rational and therapeutic).

  • The immune system in the elderly

    Throughout life, there is a gradual decrease in the relative mass of immune tissue, starting with the involution of the adenoids and thymus in young people. This process is accompanied by a parallel decrease in immunity. The classical concept of aging is based on the idea that aging is an immunodeficiency condition that leads to progressive T-cell dysfunction with age. Immune aging is mainly characterized by reduced T-lymphocyte proliferation and impaired T-helper activity, which leads to a deterioration of the cell's humoral response to T-cell-dependent antigens. This phenomenon underlies the etiology of many chronic degenerative diseases of the elderly, such as arthritis, cancer, and a complex of autoimmune diseases. This also explains the increased susceptibility of older people to infectious diseases.

    Immune function is also affected by dietary lipids, which are precursors of eicosanoids, prostaglandins, and leukotrienes; eicosanoid synthesis can be modified by dietary antioxidants such as vitamins E and C, selenium and copper. Zinc deficiency is also accompanied by dysfunction of T-lymphocytes. Thus, the use of multivitamin and mineral supplements in the elderly may lead to improved lymphocyte function and a reduction in infections.

    Adequate nutrition may be an important factor in treatment, especially in frail older people with poor immune function due to protein-energy malnutrition.

• Gerodietics

  Gerodietics is a scientific discipline that studies the nutrition of people of older age groups.

  • Basic Principles of Gerodietics

    Healthy eating and regular physical activity are key components to good health at any age. The main requirements for the nutrition of practically healthy people over 60 years of age are the basic principles of gerodietetics:

    • Correspondence of the energy value of the diet with the actual energy expenditure of the body.

      The intensity of metabolism in the elderly and old people decreases in direct proportion to the increase in age. This process involves the nervous, endocrine system, as well as muscle and connective tissues, nutrition of an individual cell and removal of metabolic products. In the senile body, energy consumption and basal metabolism decrease, physical activity decreases, and muscle mass decreases. This leads to a natural decrease in the need for nutrients and energy. The recommended calorie content is 1900-2000 kcal for women over 60 and 2000-3000 kcal for men of the same age.

    • Preventive nutrition.
    • Compliance of the chemical composition of the diet with age-related changes in metabolism and functions of organs and systems.
    • A variety of food set to ensure a balanced content in the diet of all essential nutrients.

      In the diet of practically healthy elderly and old people, they limit, although they do not exclude, rich and puff pastry products, strong meat and fish broths, fatty meat, meat by-products and eggs, fatty dairy products (due to their high cholesterol content), rice , pasta, legumes, smoked and salty products, sugar, confectionery and cream products, chocolate. Culinary food processing should provide for moderate mechanical sparing of the chewing apparatus and the gastrointestinal tract, that is, one or another degree of grinding. It is acceptable to use sweet and sour or water-diluted juices of fruits and berries, tomato juice, weak and low-fat broths, citric acid and vinegar, including apple, spicy vegetables (onions, garlic, dill, parsley, etc.) and spices. Of great importance is the regular inclusion in the diet of products that normalize the intestinal microflora of an aging organism: fermented milk drinks, fresh, pickled and pickled vegetables and fruits, foods rich in dietary fiber.

    • The use of products and dishes that have a fairly easy digestibility in combination with products that moderately stimulate the secretory and motor functions of the digestive organs, normalize the composition of the intestinal microflora.
    • Proper diet with a more even distribution of food in separate meals compared to young age.

      Regular meals, the exclusion of long intervals between meals, the exclusion of heavy meals. A 4-time diet is recommended: 1st breakfast - 25% of the daily energy value of the diet; 2nd breakfast or afternoon snack - 15–20%; lunch - 30-35%; dinner - 20-25%. At night, it is desirable to consume sour-milk drinks or raw vegetables and fruits. On the recommendation of doctors, it is possible to include unloading days(cottage cheese, kefir, vegetable, fruit), but not complete starvation. In diseases of the elderly and old people, a 5-time diet is desirable: 1st breakfast - 25%; 2nd breakfast - 15%; lunch - 30%; dinner - 20%; 2nd dinner 10% of the daily energy value of the diet.

    • Individualization of nutrition, taking into account the characteristics of metabolism and the state of individual organs and systems in the elderly and old people. It is also necessary to take into account long-term eating habits.

  • The energy value	1.4–1.8 UO
    Protein	0.9–1.1 g/kg
    Fats	30–35% depending on activity, of which 8% are saturated
    Retinol	men - 700 RE, women - 600 RE
    Calciferol	10–20 mcg
    Tocopherol	in therapeutic doses
    Phylloquinone	60–90 mcg
    Vitamin C	60–100 mg
    Riboflavin	men - 1.3 mg, women - 1.1 mg
    cyanocobalamin	2.5 mcg
    Folic acid	400
    Iron	10 mg
    Calcium	800–1200 mg
    Magnesium	225–280 mg
    Copper	1.3–1.5 mg
    Selenium	50–70 mcg
    Chromium	200–250 mcg

    Note: BRO - basal metabolic rate, PE - retinol equivalent.

    For healthy elderly and old people, there are no prohibited foods and dishes, we can talk about more or less preferred ones. Monotonous nutrition is unacceptable, as it will inevitably lead to deficient states. Physiologically, the transition of older people from the usual diet to strict vegetarianism, eating only raw food, separate meals and other non-traditional nutrition methods is not justified.

    An average daily set of food products for the elderly has been formed (without differentiation of their gender and exact age), which corresponds to the principles of gerodietetics. The presented set is designed for widely used products in the conditions of the central and western regions of Russia. For other areas, it is possible to replace them, but with similar chemical composition properties. So, for the northern regions, more than wide application products of animal origin, in particular fish products, for the southern regions - an increase in the role of fermented milk and vegetable products.

  • Products	Up to 65 years old		Over 65 years old
    	men	women	men	women
    Rye bread	100	100	100	100
    Bread made from wheat flour	200	150	150	120
    Wheat flour	10–20	10–20	10–20	10–20
    Pasta	10	10	10	10
    Grains and legumes	30	30	25	25
    Potato	250	200	200	150
    Vegetables and gourds	400	400	350	350
    Fresh fruits and berries	300	300	250	250
    Dried fruits (prunes)	25	25	25	25
    Sugar	50	50	50	50
    Lean meat	100	75	100	75
    lean fish	75	75	60	60
    Milk	150	150	150	150
    Kefir	150	150	150	150
    Cottage cheese	100	100	100	100
    Vegetable oil	20–30	20–30	20–30	20–30
    Butter	10	10	10	10
    Eggs	2-3 per week	2-3 per week	2-3 per week	2-3 per week

  • The role of individual nutrients in the diet of the elderly

    The question of the protein composition of the diet in the elderly and senile age has not been unambiguously resolved. It is known that in an aging organism, the synthesis of hormones, various protein structures, tissue regeneration, and the synthesis of enzymes, including those that break down protein-lipid complexes, are reduced. The process of digestion and assimilation of meat proteins is very complex, while the activity of digestive enzymes is reduced in old age. At the same time, the breakdown of proteins and their loss by the body increase. At the same time, it has been established that nutritional restriction, including a moderate decrease in the protein composition of the diet, which lowers immune activity at a young age, causes the opposite effect in older people: the activity of cellular and humoral immunity factors increases. Therefore, it is considered appropriate in the elderly and senile age to reduce protein intake.

    Most Russian authors recommend reducing the daily dose of protein to 1 g/kg of body weight. According to the WHO guidelines for safe protein intake, the amount of protein in the diet can be reduced to 0.9 g/kg of body weight (with a mixed diet). In the absence of liver or kidney disease, protein intake with food in the amount of 12-15% of daily calories is well tolerated. The needs of sick old people are correspondingly higher - 1–1.5 g / kg / day. Although physicians are often wary of the use of high-protein (more than 15% of calories from protein) diets in elderly patients due to fear of kidney damage, there is no evidence that patients without underlying kidney disease can develop nephropathy.

    Patients with immobilization, bedridden, or those who are in various hospitals, may have a negative nitrogen balance due to lack of motor activity. Increasing the amount of protein in the diet may not affect these processes, the appointment of a suitable exercise program can save muscle mass or at least reduce the rate of its loss.

    Read more: The role of proteins in human nutrition.

    It is important to note that older people do not tolerate a significant protein deficiency in the diet (0.8 g protein/kg body weight per day or less). At this level of protein intake, regenerative processes decrease, intoxication increases, the functions of the liver and pancreas worsen, and pathological (premature) aging is activated.

    Read more: Therapeutic nutrition for protein-energy malnutrition.

    It is important to ensure the optimal proportion between animal and vegetable proteins in the diet is 1:1.

    • animal squirrels

      From proteins of animal origin, preference should be given to proteins of fish and dairy products. Meat, especially old animals, liver, brains, fatty fish (salmon, nelma, notothenia, sturgeon, black halibut, saury, sardine, stellate sturgeon, fatty herring, large ivasi, mackerel and some other varieties) are rich in purine bases - a source of education in the body of uric acid, which contributes to the occurrence of hyperuricemia with the formation of uric acid diathesis and gout. Purine bases are converted into broths when meat, poultry or fish are cooked. This is one of the reasons for the undesirable frequent use of broths in the diet of the elderly. Another reason for the restriction of meat in old age is the appearance in the body of an excess amount of products of nitrogenous origin (azotemia) due to the weakening of metabolic processes. In addition, fatty meats contain a significant amount of cholesterol.

      Elderly people are advised to limit the consumption of meat and meat products. It is advisable to arrange fasting days 1-2 times a week, and on the remaining days, use a meat dish once in the diet (100 g in finished form). It is preferable to cook meat, fish dishes, as well as poultry dishes in boiled form. The most useful is river fish (perch, pike, carp), and from marine fish- cod varieties. The amount of fish in the diet should be brought up to 75 g per day.

      It is recommended that older people introduce up to 30% of proteins into the diet from dairy products (in this case, fat-free or low-fat products should be preferred). This is primarily cottage cheese, the amount of which in the daily diet can be 100 g. Low-fat cottage cheese is recommended as it has less calories and a higher protein content. Cheeses are included in the diet. In amounts of 10–20 g, any type of cheese may be allowed for elderly and old people. However, we should not forget that cheese, as one of the main suppliers of calcium to the body, at the same time contains a lot of fat, cholesterol and table salt. It is better to choose mild and unsalted varieties.

      With good tolerance, milk should be present in the diet of an elderly person (300–400 g per day). In old age, a decrease in the activity of digestive enzymes increases the likelihood of poor tolerance to fresh milk (flatulence, rumbling, diarrhea). Tolerance improves when drinking boiled milk or when adding it in small amounts to tea, coffee. Fermented milk products are especially useful - kefir, yogurt, acidophilus. Their positive effect is mainly due to the presence of lactic acid bacillus, which maintains the normal composition of the intestinal microflora. It is recommended to consume 200 g of kefir or other fermented milk products daily, preferably in the evening, before going to bed.

      An elderly person can afford 2-3 eggs per week, preferably soft-boiled or in the form of an omelette, or as an addition to meals.

    • vegetable proteins

      Vegetable proteins should make up half of the protein portion of the diet. Plant proteins are obtained mainly from cereals and leguminous plants. However, these products are often poorly tolerated by older people, causing increased gas formation, belching, heartburn, rumbling, and upset stools. Only green peas or green beans are usually added to the diet as a side dish in small quantities. In addition to being poorly tolerated, a major reason for restricting legumes is their high purine content. Of the cereals, buckwheat and oatmeal are the most useful. Adding milk to these cereals brings their amino acid composition closer to the optimal one. With good tolerance, millet and barley porridge. Rice is limited due to its fixing action. Semolina is recommended for those patients who, for one reason or another, need a sparing diet.

      source vegetable protein serving bread. The introduction of rye bread into the daily diet is recommended. It is better to use wholemeal bread or bread with bran. Rye bread is more complete in terms of amino acid composition. Along with other cereals, rye bread is a source of vitamin B, minerals and fiber. In cases where rye bread causes heartburn or other symptoms of dyspepsia, enhancing fermentation processes, it is better to use it dried. Bread made from wheat flour or bran, promoting bowel movement, improving its motor activity, does not discomfort. Elderly people are recommended to consume up to 300g of bread per day. Of these, 1/3–1/2 of the norm is bread made from wholemeal flour or rye.

    Dietary fat intake can be reduced in the elderly to 30% or less of the total calorie intake without any negative effects on nutritional balance. It is the reduction in fat intake that is the main characteristic of the so-called "healthy diet", which is designed to prevent the development of atherosclerosis. However, it is also important that excessive fat restriction (less than 20% of daily calories) can affect the quality of nutrition. A limit on the amount of fat in the diet of the elderly is set: 70-80 g / day, and for people over 75 years old - 65-70 g / day.

    Read more: The role of fats in human nutrition.

    With parenteral nutrition, up to 40–60% of the energy needed by the body can be provided by fat, although with long-term artificial nutrition, fat intake should be reduced to 30% of daily energy consumption.

    It is very important to observe a certain ratio between animal and vegetable fats.

    In recent decades, a technology has been developed to create alternative food products of plant origin, capable of replacing animal products in their nutritional value. Soy isolates turned out to be such food products. Soy isolates have a balanced amino acid composition of soy proteins, a high content of lipotropic substances and are highly digestible.

    • Animal fats

      Saturated fat should not exceed 10% of the total dietary fat.

      Among animal fats, butter occupies the main place for the elderly. It belongs to milk fat and is the most easily digested. It is important that butter contains vitamin A. Usually, 15 g of butter per day (together with cooked food) is recommended, adding it immediately before serving the dish. It should be borne in mind that butter is resistant to heat treatment. In patients with hyperlipidemia, the intake of butter, like other animal fats, should be limited.

      Acceptable for the elderly is the consumption of 300 mg of cholesterol per day. Serum total cholesterol and low-density lipoprotein levels increase linearly from 30 to 50 years of age, reach a plateau at 60 and 70 years of age, and fall after 70 years of age, while the average value of high-density lipoprotein remains constant throughout life.

      In the diet of older people, substances rich in cholesterol and vitamin D are prohibited or limited (egg yolks, brains, fish oil, fish roe, internal organs animals, fatty meat and fatty fish, lard, creams, muffins, cream, sour cream and other fatty dairy products). Restrictive dietary measures regarding foods rich in cholesterol should be strictly individualized.

      It should be borne in mind that a decrease in exogenously incoming cholesterol below the physiological norm is fraught with the development of a number of deficiency symptoms in the body in older people. With hypocholesterolemia, the conduction of impulses along the nerve trunks is disrupted and the activity of the nerve cell is inhibited, since cholesterol is a structural element of cell membranes and is part of the membranes of the nerve trunks. First of all, with a deficiency in cholesterol consumption, signs of deterioration in psycho-emotional activity develop, in the future, symptoms of a violation of the activity of peripheral nervous system with sensitivity disorders, paresthesia, sciatica, etc. Due to insufficient intake of cholesterol from food, hormonal insufficiency occurs. This is due to the fact that cholesterol is the starting material for the synthesis of steroid hormones of the adrenal glands and gonads. Clinically, this can be manifested by a wide range of clinical signs, combined into a syndrome of rapidly progressive aging.

      Significant restrictions on animal products can create a deficiency in the body of an elderly person of a number of important metabolic substrates, primarily plastic proteins, fats, minerals, and vitamins.

    • Vegetable oils

      The quota of consumption of vegetable oils in the diet of the elderly should be increased.

      However, this increase must be done with caution. An uncontrolled increase in vegetable oils in the diet can cause a laxative effect and adversely affect the patient's health. Vegetable oils are important due to their presence of polyunsaturated fatty acids, phosphatides (lecithin) and phytosterols. Together, all these biologically active substances have a beneficial effect on cholesterol metabolism.

      With a deficiency of vegetable oils in the diet, a "fatty" liver (steatosis and steatohepatitis) can form. Vegetable oils contain tocopherols, which have an antioxidant effect. These substances neutralize free radical reactions, improve DNA metabolism, reducing degenerative changes in organs during aging. The most important property of vegetable fats is their lipotropic effect. Unsaturated fatty acids, due to the selectivity of their interaction with saturated fatty acids, prevent excessive accumulation of lipids and their metabolites in tissues. Due to these features of metabolism, phospholipids are referred to as means of preventing and treating premature aging, atherosclerosis, fatty degeneration of the liver, pancreas, and other organs.

      The good choleretic effect of vegetable oils is of great importance for the elderly in connection with the typical bile stasis syndrome for this period. Also vegetable oils have a laxative effect.

  • Nutritional support for the elderly and senile

    When developing a therapeutic nutrition plan for elderly patients, more factors should be considered than for younger patients.

    In the diet of the elderly, of course, any food should be present, and the diet should be mixed, varied. It is not recommended to completely exclude favorite foods from the diet and replace them with food that a person has never eaten.

    In old age, changes in the chewing apparatus may occur. Hence, there are requirements for the choice of products and methods of culinary processing. Preference should be given to foods and dishes that are easily digested and easily absorbed. Meat in chopped form, fish, cottage cheese are more easily exposed to the action of digestive enzymes. Increasing the amount of dietary fiber in the diet helps to increase intestinal motility. Adequate fluid must be provided for normal bowel function.

    From vegetables, preference should be given to beets, carrots (fresh, mashed), zucchini, pumpkin, cauliflower, tomatoes, mashed potatoes. Of the fruits, all sweet varieties of berries and fruits, citrus fruits, apples, black currants, lingonberries are recommended. Cabbage should be limited in the diet, as it enhances fermentation processes.

    The temperature of the food matters, it should not be too hot and not too cold.

This age covers the periods of a woman's life from 55 to 75 years, and men - from 60 to 75 years. In general, it is characterized by an increase in the signs of aging and an acceleration of the aging process itself. If, according to external signs, an elderly person of the first 5-6 years and a person of mature age (the last 5-6 years) in most cases still differ slightly, and the age limit itself is practically indistinguishable, then by the end of the old age period it is difficult to confuse people of these ages.

Aging is a natural manifestation of a multitude of diverse life processes occurring with different signs.

Older people bear the visible imprint of the years they have lived. First of all, this concerns the appearance - characteristic changes in hair, skin, general outlines of the figure, gait, etc. Senile graying usually begins from the head, sometimes from the beard, and somewhat later appears in the hair of the armpits and eyebrows. Graying of chest hair is not observed until the age of 40. True, cases of premature graying are known, which can be of a hereditary familial nature.

Changes in the skin are characteristic. By the age of 50, the skin color of the face acquires an earthy-pale tint, which intensifies with increasing age. The skin loses elasticity, pigment spots of varying severity appear, signs of keratinization. At the age of 50-60, wrinkles are found on the earlobes, bridge of the nose, chin and upper lip. Later, wrinkles begin to cover the skin of the cheeks, forehead, neck, becoming deeper and more noticeable every year. It should be borne in mind that wrinkles may appear on the skin of the face and neck earlier, especially in individuals who spend a lot of time on fresh air, under the scorching sun and wind.

In an elderly person, with rare exceptions, the figure, posture and gait noticeably change, which is associated with age-related changes in the joints, muscles and skeleton. The mass and strength of the muscles, the elasticity and mobility of the ligamentous apparatus gradually decrease, the degree of bone mineralization increases, which increases their fragility and the likelihood of fracture in the event of a fall or severe injury. The body acquires heaviness, the back - roundness and stoop. Due to the flattening of the intervertebral discs, growth decreases. The gait becomes heavy, slow, but not yet "shuffling", which is more common in old age. These symptoms are aggravated when a person is obese.

Changes in the activity of most internal organs and systems continue to grow. A decrease in the mass of the heart, the elasticity of blood vessels is accompanied by a decrease in heart rate and a decrease in the volume of blood passing through the cardiovascular system per unit time. By the way, these changes occur against the background of aging of other organs and tissues and therefore are “convenient” for the heart, which no longer has to sharply speed up its work and work at the limit of its capabilities.

Significant age-related changes occur in the respiratory system. Due to the decrease in the elastic properties of the lung tissue, the vital capacity of the lungs decreases and the amount of air constantly remaining in the lungs increases. In addition, due to the progressive ossification of the costal cartilages and atrophic changes in the tendons and respiratory muscles, there is a decrease in the mobility of the chest. As a result of these changes, breathing becomes superficial, rapid. The lungs no longer cope with their task, especially during physical exertion - a person suffocates, he has shortness of breath, he begins to cough. Excess body weight, smoking, diseases of the respiratory system only exacerbate these manifestations.

Old age affects the digestive and excretory systems.

The genitourinary system is characterized by a number of manifestations, in particular in men due to the peculiarities of their anatomical structure. After 50, and more often after 60 years, 1/3 of all men begin the process of prostatic hypertrophy, which, pinching and squeezing the ureter, causes difficulty urinating. Sometimes hypertrophic changes develop into a cancerous process that affects the prostate gland. In all cases of difficulty urinating, older people are strongly advised to consult a urologist.

Atrophic changes in the nervous structures occur, their blood supply worsens, individual connections with a number of other body systems (primarily with the endocrine system) are disrupted. On the other hand, the majority of older people clearly have disturbances in the processes of excitation and inhibition, their relationships. Memory impairment may also occur. But the nervous system and the brain have colossal reserve capacities for timely and sufficiently effective compensation for disorders caused both by age-related changes and those introduced from the outside (injuries, etc.). Therefore, it would be premature to talk about "senile" changes in the nervous system. It is only necessary to take into account the possible and actually acting factors that affect the functioning of the nervous system. These include brain injuries, impaired blood supply, infectious diseases that in one way or another affect the activity of the brain (not only neuroinfections), intoxication, now we can talk about radiation effects on the nervous system, brain tumors of various origins and localizations, etc. . “Laziness of the mind” should also be attributed to destructive factors for brain activity, since active mental activity contributes to the development of numerous new connections between nerve cells and activates their biochemical activity. Taken together, these processes determine the mobilization of that reserve of brain power that ensures its operation in adverse conditions (in this case, age-related changes).

Now let's consider an elderly person from the point of view of the mental changes that occur with age, as well as those social conditions in which he lives and exists. Let's remember what age interval occupies the old age. At this time, most people are either going to retire or have been receiving it for a long time. A sharp break from your favorite and familiar work, the work team with which you have been closely and for a long time connected, the violation of a long-term life stereotype is a powerful stress factor for the nervous system and psyche, the action of which cannot pass without leaving a trace. A person who has taken a "deserved rest", retired, seems to be hanging in the air: he is no longer needed by production, he does not need to rush to work in the morning; his children have grown up and are busy with their own problems, most of them have their own families, children. Material wealth is sharply reduced. And ahead - old age with its illnesses, infirmity and the need for help. All this gives rise to pessimism, depression. It is good if a person is able to continue creative activity and find in it calm and compensation for the former way of life. He especially needs a garden plot, a dacha where he could spend his strength.

Elderly, or retirement, age in terms of mental experiences can be considered decisive. If a person manages to find delight in his grandchildren, his own occupations in the garden, summer cottage, fishing, home improvement, if he finally uses the opportunities that were constantly missed earlier in his creative development, going to museums, exhibitions, theaters, etc., then it is enough easily and painlessly switch to a new mode of life. Otherwise, this transition becomes extremely painful both for the person himself and for those around him and those close to him.

Old age requires a reasonable revision of one's capabilities in terms of both physical activity and the organization of one's rest, habits, and the nature of nutrition. What was possible at 50 or 60 becomes unacceptable at 70. The intensity and duration of physical activity should be reduced, rest should be sufficiently long and comfortable, food should be easily digestible and small in volume.

Society should not forget people of older generations who are leaving or have already retired. Moreover, personal activity, participation in professional and social life have become necessary for most people who have crossed the retirement threshold.

Senile age- conventionally allocated period of human life from 75 to 90 years. In general, the age periodization of the second half of a person's life (that is, after about 35 years) is quite complicated. So, at the end of the 19th century and the beginning of the 20th, people who had barely passed the age of 45-50 were classified as old people. Later, due to the increase in human life expectancy, ideas about the time of onset of the elderly and senile age began to shift: one can say that old age “recedes”, and the duration of young ages increases.

Considering the morphological and functional changes characteristic of old age, it should be emphasized that there are no fundamentally different changes in relation to those that are characteristic of old age in old age. There is only their deepening and a more distinct manifestation. In particular, the skin, especially of the hands, face and neck, becomes thinner, wrinkled, and senile age spots appear on it. Hair turns gray, thins, becomes brittle. Muscle atrophy, a sharp decrease in the thickness of subcutaneous adipose tissue lead to the formation of many skin folds. The eyes lose their inherent brilliance, become dull, in some cases there is eversion of the eyelids, ptosis. Growth is reduced, many old people have excessive stoop. The gait becomes uncertain, slow.

The aging process does not bypass the internal organs. These organs, in accordance with the laws of senile wilting, also gradually reduce their activity.

The totality of senile changes, pathological changes caused by external factors, determine the picture of senile pathology. A decrease in the body's ability to adapt to acting factors also causes the development of metabolic or functional disorders, the most common of which are atherosclerosis, accompanied by impaired blood supply to the heart, followed by heart failure; angina pectoris (angina pectoris); myocardial infarction; violations of the blood supply to the brain with disorders of the activity of various organs. Very often there is hypertension, which is usually combined with manifestations of atherosclerosis. In old age, numerous diseases of the musculoskeletal system (rheumatism, osteochondrosis, sciatica, etc.), diseases caused by functional disorders in the endocrine sphere (diabetes mellitus, etc.) are not uncommon. Violations at the cellular level, in the genetic apparatus of the cell, lead to the development of various tumors.

The greatest changes are manifested in the mental sphere of an old person: the mobility of nervous processes worsens, memory for recent events worsens, and emotional instability develops. These processes are accompanied by a weakening of the intensity of perception of new impressions, as if "flight into the past", into the power of memories, as well as "obsession" with thoughts about one's health, "sores" and ailments. Very noticeable conservatism in judgments and actions, a tendency to preach; some affectations are observed, expressed in some cases by previously unusual callousness, distrust, capriciousness, inadequate touchiness. There is a fairly widespread opinion that in old age the characterological traits of a person are sharpened and more clearly manifested. In many people of this age, the described changes in the psyche are not pronounced and, according to the prominent Soviet pathologist I.V. Davydovsky, they are in the nature of an "ailment of old age." However, in some cases they acquire a painful character and can serve as the first manifestations of senile dementia.

The psyche of an old person is extremely susceptible to the influence external factors, which is based on a change in the social status of the individual, role and place in society (perhaps this explains the desire for suicide that is often found in old people).

Thus, people of senile age, due to the specific features of their psyche, a certain helplessness, require a special attitude towards themselves, care from relatives, acquaintances and just those around them.

Previously, this role was played by religion, the church, the way of life. In our time, with its rapid pace of life, when people have lost the habit of looking around and the principle of “help your neighbor” has practically ceased to operate, the need has come to stop, look around and remember that each of us will be old and will also need help.

The effect of any factors on human life and health should be considered in a single complex. For example, the social environment, living conditions determine the nature of nutrition, the consumption of alcohol, tobacco, drugs, etc. This, in turn, affects the state of health, the body's resistance, and its vitality. A decrease in these indicators inevitably leads to the emergence of diseases, an increase in the death rate, and ultimately to a decrease in the life expectancy of the population. A targeted impact on these connections will increase the biological capabilities human body, delay old age, facilitate the aging process itself.

Among the most important problems of our time facing the world community, the problem of population aging has come to the fore.

The scientific approach to the problem of aging began to develop relatively recently. One of the reasons for this is the rapid development of biological science, the emergence of new methodological approaches that made it possible to penetrate into the innermost secrets of a living organism, to understand the basic laws of its development and life, and thus put the question of the causes and mechanisms of aging on an experimental basis.

Another reason is that for the first time in the history of medical science, despite tremendous advances in the understanding, recognition and treatment of diseases, the average life expectancy of a person, approaching 70 years in economically developed countries, has either stopped increasing or is increasing extremely slowly.

This situation makes the medical and social problems of the elderly and senile people very relevant at the present time.

Age classification

The definition of old age refers to the number of "eternal problems". There are discussions around what is considered old age, its first manifestations, what is the age of old age and what are its boundaries. Difficulties in definition are connected, first of all, with the fact that aging is a long, smooth process, there is no exact boundary that separates old age from middle age. In general, aging is an individual process, in some people it starts earlier, in others later.

Comparison of various age classifications gives an extremely varied picture in determining the boundaries of old age, which range widely from 45 to 70 years. It is characteristic that in almost all age classifications of old age one can see a tendency towards its differentiation into sub-periods. At the same time, it should be taken into account that the aging process does not end with its onset, it continues, and there are big differences between aging people.

At different periods in the history of society and in different cultures the beginning of old age was defined as follows: Pythagoras - 60 years old, Chinese scientists - 70 years old, English physiologists of the 20th century - from over 50 years old, German physiologist M. Rubner - 50 years old age, 70 years old - respectable old age. In recent decades, it has been proposed various options age classification for the late period of human life.

D. Bromley's classification distinguishes five development cycles. In addition, each cycle in turn is divided into several stages. The “adulthood” cycle consists of three stages: early adulthood (from 21 to 25 years old), middle adulthood (from 25 to 40 years old), and late adulthood (from 40 to 5 years old). The pre-retirement age (from 55 to 65 years) stands out as a special transitional stage. The cycle of "old age" begins at the age of 65 and also includes three stages: retirement (from 65 years old), old age (from 70 years old), the third stage, designated as the finish line, essentially includes the period of senile illness and dying.

Yu.B. Garnavsky proposes to divide the entire period of late age into separate groups: old age (it is also called involutional or presenile) - from 50 to 65 years; senile age - from 65 and above.

E.S. Averbukh, a domestic psychiatrist conventionally distinguishes the age of 45-60 years as a post-reproductive (climacteric) period preceding the elderly (presenile - 60-75 years) and senile (75-90 years) age. According to the author, people over 90 years old should be considered centenarians.

According to the documents of the World Health Organization (WHO), the age from 60 to 74 years is considered as old; 75 years and older - old people; age 90 years and older - centenarians.

In foreign literature, there is a distinction between "young elderly" - 65-74 years old, "old" - 75-84 years old and "very old" - 85 years and older. WHO, referring to the UN decision of 1980, the age of 60 is recommended to be considered as the border of transition to the group of the elderly. According to international criteria, a country's population is considered old if the proportion of people aged 65 and over exceeds 7%. According to this indicator, the population of Russia can long ago be considered as such, because about 20% of its citizens (that is, every fifth Russian) belong to the above age category. And in several dozen regions of the country, the proportion of the elderly population in rural areas already exceeds 30%.

Of course, all these divisions are arbitrary, it is impossible to establish the exact boundaries of different periods of human life, since it is a continuous development, and age-related changes occurring in the body are numerous and varied. So, conditionally, a person is considered old from the age of 75, that is, 15-20 years after he retires. In domestic science, the following scheme of age periodization:

• - Elderly age 60-74 years for men, 55-74 years for women.
• - Senile age 75-90 years for men and women.
• - Long-livers - 90 years and older men and women.

There is also a retirement age, the boundaries of which are set by the state. When determining the retirement age, they proceed from the chronological age - the number of years lived.

There is the concept of functional age, which reflects the age-related dynamics of physiological functions, is determined by the genetic component, lifestyle, past diseases, stressful situations, physical, mental and intellectual activity; psychological age - a group of indicators characterizing age-related measurements of the psyche; biological age - an indicator of the level of deterioration of the structure and functions of the body.

The distinctions for periods are conditional, since the calendar and biological, as well as psychological age do not always coincide.