Yuliya Safonova
@szgmu.ru
Department of Geriatrics
North-Western State Medical University named after I.I. Mechnikov
RESEARCH, TEACHING, or OTHER INTERESTS
Geriatrics and Gerontology, Rheumatology
Scopus Publications
Scholar Citations
Scholar h-index
Scholar i10-index
Scopus Publications
Charlotte Beaudart, Noémie Tilquin, Pawel Abramowicz, Fátima Baptista, Dao Juan Peng, Fabiana de Souza Orlandi, Michael Drey, Marta Dzhus, Raquel Fábrega-Cuadros, Julio Fernandez-Garrido,et al.
Elsevier BV
Yu. A. Safonova, E. G. Zotkin, and N. V. Toroptsova
IMA Press, LLC
Objective: to assess the quality of life (QoL) using general and special questionnaires and to identify the relationship between fatigue and sarcopenia (SP) in elderly and senile people.Patients and methods. The cohort study included 230 patients, including 177 women (77%) and 53 men (23%) over 65 years old (median age 75 [68; 79] years). The presence of SP was determined according to the criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2, 2018). QoL was studied using the general questionnaires EQ-5D, SF-36 and a special questionnaire SarQoL, the level of fatigue – using the FACIT-F questionnaire. To assess the possibility of using the FACIT-F scale for SP screening, its sensitivity, specificity, diagnostic accuracy, positive and negative predictive value were determined, a receiver operating characteristic (ROC) curve (ROC analysis) was constructed, and the area under the ROC curve (AUC) was calculated.Results and discussion. The assessment of QoL using the EQ-5D and SF-36 questionnaires did not reveal significant differences between the groups of patients with and without SP (p>0.05). When analyzing the state of health in the study cohort using the special SarQoL questionnaire, the overall indicator was 63.12±18.83 points, while in patients with SP it was significantly lower than in patients without SP (50.65±14.23 and 75,10±14.46 points, respectively; p<0.001). The mean score for all domains was also lower in the presence of SP than in its absence (p<0.001).The level of fatigue on the FACIT-F scale ranged from 10 to 52 points and averaged 32.5 [29.1; 35.3] points, while in patients with SP the overall score was lower than in elderly people without SP (25.1 [22.13; 29.23] and 39.8 [36.4; 42.4] points respectively; p<0.001). In patients with severe fatigue, SP was diagnosed 4.6 times (95% confidence interval, CI 2.80–7.57) more often than in those without it (p<0.001). Fatigue was associated with senile age, underweight, falls in the previous year, weak muscle strength, low SPPB test scores and an appendicular muscle mass index, CRP >10 mg/L (p<0.05).The possibility of using the FACIT-F questionnaire for screening patients with SP was evaluated. Its sensitivity reached 76%, specificity – 73%, positive predictive value – 53%, and negative predictive value – 88%, diagnostic accuracy – 74%. The area under the ROC-curve (AUC) was 0.726 (95% CI 0.627–0.826; p<0.0001).Conclusion. It has been shown that the general questionnaires EQ-5D and SF-36 do not reflect the true QoL impairment in SP. A significant deterioration in the state of health in elderly people with SP can be identified by a special SarQol questionnaire. The FACIT-F fatigue scale can also be used to screening in SP.
O. M. Lesnyak, E. N. Gladkova, K. E. Zotkina, A. L. Grigoryeva, Yu. A. Safonova, O. Yu. Kuznetsova, and M. A. Pokhaznikova
Mediar Press
The global diversion of health resources during the COVID-19 pandemic from the provision of routine medical care, and the more frequent and severe course of this infection in older patients justify the need to study the impact of the pandemic on the management of patients with osteoporosis.Aim – to assess the impact of the COVID-19 pandemic on the management of patients with osteoporosis, as well as the impact of anti-osteoporotic drugs on the incidence of COVID-19.Material and methods. A cross-sectional study was conducted, including a telephone survey and analysis of outpatient records of 304 patients with osteoporosis, who were recommended therapy with anti-osteoporotic medications. The average age was 70.8±8.8 years. The vast majority of patients took bisphosphonates in oral or parenteral forms.Results. Problems with the timely conduct of laboratory tests were noted by 91 (30.4%) subjects, DXA testing – 98 (32.8%). 65 (22.1%) were unable to receive the drug in a timely manner. Problems were more common when taking parenteral drugs (p=0.002). The cumulative incidence of COVID-19 was 12.2%, which is twice as high as in the population. There was a tendency to a lower incidence of confirmed SARS-CoV-2 infection when treated with denosumab or zoledronic acid. COVID-19 cases were not associated with either a vitamin D dose or a 25(OH)D level.Conclusions. During the COVID-19 pandemic, there is a significant decline in the quality of medical care for patients with osteoporosis, which cannot but lead to a new epidemic in the future – an epidemic of low-energy fractures. Our data confirmed the predisposition of older age groups to a higher incidence of COVID-19. However, there is no clear association of osteoporosis therapy with the risk of developing clinical manifestations of COVID-19.
J. A. Safonova and G. M. Glazunova
Pleiades Publishing Ltd
Yu. A. Safonova and E. G. Zotkin
Mediar Press
Yu. A. Safonova, E. G. Zotkin, and N. V. Toroptsova
Mediar Press
These clinical guidelines have been developed under the auspices of the All-Russian public organization «The Association of Rheumatologists of Russia» and the public organization «Russian Osteoporosis Association» and are dedicated to the diagnosis of the risk of falls and their prevention in elderly people who have a high frequency of falls and their serious consequences as injuries varying in severity, as fractures, developed pain, a loss of ability to perform everyday activities and to take care of themselves. The paper presents risk factors for falls and risk assessment methods and formulates main provisions for preventing falls in older people, by taking into account their place of stay: at home, hospital or social services facilities.
Yu. A. Safonova and E. G. Zotkin
Mediar Press
Pathological changes of large joints (knee, hip) in osteoarthritis (OA) are accompanied by the development of muscle weakness, decreased proprioception and imbalance.Objective: assessment of skeletal muscles state in women over 65 years old with OA of large joints and determination of the main factors affecting the risk of sarcopenia.Subjects and methods. In 159 women with OA (mean age 74±6 years), muscle mass was assessed with the appendicular lean mass index (ALM) using dual-energy X-ray absorptiometry (DXA). Muscle strength was measured by hand dynamometer, muscle function was determined by the results of a brief set of physical activity tests (short physical performance battery – SPP). The quality of life was analyzed by the EQ-5D questionnaire, pain assessment was carried out using a visual analog scale (VAS).Results and discussion. Patients with sarcopenia were significantly more likely to have lower rates of ALM index (p<0.001), body mass index (p<0.001) and muscle strength (p<0.01). The incidence of sarcopenia increased with age (p<0.01). Muscle function measures are reduced in women with OA, regardless of the presence of sarcopenia. Falls in the previous 12 months before inclusion in the study in patients with sarcopenia were observed significantly more often than without sarcopenia: in 90 and 24.8% of cases (95% CI 78.2–96.7 and 17.0–34.0, respectively p<0.001). Clinically expressed pain in large joints in patients with and without sarcopenia was found with the same frequency. The average value of the EQ-5D index in women with sarcopenia was significantly less than without sarcopenia (0.48±0.22 and 0.74±0.27 respectively), mainly due to a decrease of the usual daily activities (p<0.01). However, in women over 85 years of age, the quality of life was comparable regardless of the presence or absence of sarcopenia.
Yu. A. Safonova, O. M. Lesnyak, I. A. Baranova, A. K. Suleimanova, and E. G. Zotkin
Mediar Press
The aim is to carry out language adaptation and validation on the Russian sample of a special SarQoL questionnaire, designed to assess the quality of life of elderly people with sarcopenia. Material and methods. 100 patients over 65 years, mean age 74.0±6.5 years, observed on an outpatient basis were included. 50 from them had sarcopenia and 50 participants were without it. The diagnosis of sarcopenia was based on criteria developed by the European working group on sarcopenia (EWGSOP, 2010). The validation procedure was carried out in accordance with the Protocol. Results and discussion. There was a significant decrease in the overall quality of life according to SarQoL questionnaire in patients with sarcopenia compared with the control group without sarcopenia (50.65±14.23 and 75.10±14.46, respectively; p<0.001). High internal consistency of the SarQoL (Cronbach's á coefficient 0.924) was revealed. A significant positive correlation of domains with the overall SarQoL index in the range from r=0.37, p=0.0083 to r=0.92, p<0.001 was established. Moderate correlations of SarQoL with some domains SF-36 and the EQ-5D questionnaires were revealed. High internal consistency (ICC) of 0.935 (95% CI 0.91-0.96) was found. Conclusion. The Russian version of the SarQoL questionnaire is valid, consistent and reliable and can be used to assess the quality of life in older patients with sarcopenia.