Allostatic load as a method of objectification of age-related viability of patients with ophthalmopathology
Background: In recent years, the elderly have seen an increase in the prevalence of combined ophthalmic diseases that change their functional activity in everyday life and society. In gerontological practice, tests and scales that differ significantly in the subjective perception of patients are mainly used to assess age-related viability. Allostatic load, which is an objective reflection of age-related viability, has not been practically studied in patients of older age groups in the presence of ophthalmic diseases. The aim of the study:To analyze the age-related viability in elderly patients with ophthalmic pathology based on allostatic load. Materials and methods: The study of age-related viability was conducted in the Tambov Branch of the Academician S.N. Fedorov Eye Microsurgery in 2018-2020 in 45 60-74-year-old patients with primary angle-closure glaucoma, 52 60-74-year-old patients with diabetic retinopathy, and 68 60-74-year-old patients with combined angle-closure glaucoma and diabetic retinopathy. To assess the age-related viability, the allostatic load was determined by a set of indicators: body mass index, blood content of C-reactive protein, homocysteine, total cholesterol, triglycerides, blood albumin level, glomerular filtration rate, diastolic and systolic blood pressure. Results: There are significant differences in the indicators of allostatic load in elderly patients with comorbid ophthalmic pathology, compared with the control. In comorbid primary angle-closure glaucoma and diabetic retinopathy, the allostatic load is 3.4±0.3 points, which is statistically significantly higher than in patients of the same age with primary angle-closure glaucoma (1.8±0.2 points) and diabetic retinopathy (2.4±0.2 points). All components of allostatic load in patients aged 60-74 years with combined primary angle-closure glaucoma and diabetic retinopathy differ significantly and have deviations from the reference values, with the exception of glomerular filtration rate. The level of albumins is 51.2±0.8% vs. 57.8±0.6 in primary angle-closure glaucoma, body mass index 28.8±0.5 kg / m2 vs. 24.7±0.3 kg / m2, C-reactive protein 13.1±0.3 mg / l vs. 6.7±0.2 mg / L, glycated hemoglobin 6.8±0.4 % vs. 4.1±0.2 %, systolic blood pressure 151.6±2.0 mmHg vs. 142.8±1.9 mmHg. Conclusion: Allostatic load in elderly patients with ophthalmic diseases can serve as an objective method for assessing the age-related viability of elderly patients with visual organ pathology.