During the discussions of the XVII International forum «The Senior Generation», St. Petersburg rheumatologists named the disease as the scourge of the modern elderly, and also talked about the «paradox of obesity».

 

The event was held at Expoforum as part of the conference «Pushkin Readings-2024: Innovative digital solutions to socially significant problems in geriatrics».

Experts in the study and treatment of rheumatic diseases shared with the participants of the discussion information that these diseases are steadily increasing in the world. And overweight and obese people have the greatest chance of deteriorating health. Thus, exceeding the body mass index (BMI) by just one standard deviation significantly increases the risk of developing diseases: rheumatoid arthritis – by 52 percent, osteoarthritis – by 49, gout – by 70, and psoriatic arthropathy – by 80 percent. The effect of BMI is more pronounced in women with regard to gout and psoriasis.

At the same time, overweight people have a higher bone density and a fracture of the proximal femur is much less likely to occur. And the reason is that adipose tissue is a source of estrogen synthesis, and they, in turn, protect bone tissue. Overweight people are not as afraid of fractures as dystrophic ones. This is the «paradox of obesity»: overweight and a high BMI reliably protect a person from osteoporosis (a metabolic disease of the skeleton characterized by a decrease in bone density). Osteoporosis is a scourge of the elderly, and its most striking manifestation is pathological fractures in typical places. And the most catastrophic, leading to severe disability, is a fracture of the femoral neck and spine.

Overweight elderly people have their own risks: it has been proven that obesity is accompanied by an increased risk of falls. «You and I know that those who fall more often break bones more often», says Olga Lesnyak, professor of the Department of Family Medicine at the Northwestern State Medical University named after Mechnikov, President of the Russian Association for Osteoporosis. – But I want to clarify that obese people just break other bones than people with a normal BMI. They more often injure the shin or humerus, less often the femur, vertebrae, pelvis or forearm, and therefore their fractures sometimes do not fall into the statistics of the «classics of osteoporosis».

The topic of rehabilitation of patients with osteoporosis was continued by Oksana Inamova, Chief Physician of St. Petersburg State Medical Institution «Clinical Rheumatology Hospital No. 25 named after Nasonova». «In general, the elderly population is growing, and the average life expectancy of a Russian citizen will reach 80 years in 2050», the expert emphasized. «Petersburgers are leaders among centenarians». If in 1993 the life expectancy of a citizen of St. Petersburg was only six months longer than the Russian average, then in 2024 it was already 6 years. «I am sure that it is largely thanks to our healthcare that the residents of Northern Venice are living longer. And it is precisely this category of patients that we will be dealing with more and more closely, and there will be more and more problems related to old age», Oksana Inamova shared with colleagues.

It would seem that the incidence of osteoporosis in St. Petersburg is definitely growing. But experts are sure: this is not due to an increase in the number of patients, but to an improvement in the diagnostic capabilities of the region. It’s just that osteoporosis has become more common, and at an early stage. The number of densitometers has increased in the city. In 2024 alone, four new devices were purchased, and remote parts of the city, such as Kolpino, have their own densitometer. «The incidence will «grow» because we will diagnose better», Oksana Inamova has no doubt.

At the end of the discussion, the experts deduced the formula for healthy longevity of the musculoskeletal system of modern man. Maintaining a normal body weight, sufficient physical activity, a healthy and nutritious diet, plus adequate vitamin D levels are the key to healthy fat, muscle and bone tissue.