SPECTRUM OF AUTONOMIC NERVOUS SYSTEM DISORDERS IN THE ELDERLY DEPENDING ON GENDER

Аннотация

INTRODUCTION The diagnosis of “autonomic dysfunction The syndrome of vegetative dysfunction is syndrome” (ADS) is not presented in ICD-10. The currently considered as a comorbid pathology of code G90 – disorders of the autonomic nervous chronic cerebral ischemia, accompanying it as it system [1] – is used as an official diagnosis for develops. With increasing age, the patient autonomic disorders. However, ADS is a disorder experiences gradation of vegetative dysfunction. that is common in the population. One of the most Changes occurring in the vegetative nervous common reasons for visiting primary care system precede the neurological disorders that physicians is severe physical symptoms, such as arise subsequently and serve as a manifestation of heart pain or gastrointestinal disorders [4]. maladaptive reactions. Moreover, every fifth visit to primary care is The aim of the study. To identify the frequency associated with physical symptoms that physicians and nature of neurovegetative disorders cannot attribute to organic pathology or mental depending on gender in elderly people. disorder. These unexplained symptoms can range METHODS from acute to chronic and from mild to severe, and contribute significantly to individual disability and The study included 163 elderly patients aged 60 to the global burden of disease. 74 years (average 67.2+6.8 years) with clinically and laboratory confirmed stage 2 chronic cerebral https://www.theamericanjournals.com/index.php/tajmspr 19 THE USA JOURNALS THE AMERICAN JOURNAL OF MEDICAL SCIENCES AND PHARMACEUTICAL RESEARCH (ISSN – 2689-1026) VOLUME 06 ISSUE11 ischemia syndrome (CCIS2) and autonomic Group I consisted of men (58 patients), Group II dysfunction syndrome (ADS) (106 (64.4%) consisted of women (106 patients). The average women, 58 (35.6%) men). All patients were age of women was 68.3+3.9 years, and of men - hospitalized in the neurology department of the 64.1+4.5 years. The control group (CG) consisted Andijan State Medical Institute. of 20 patients who did not have clinical and laboratory criteria for CCI and SVD, comparable in By gender, the patients were divided into 2 groups: gender and age. (Table 1). Distribution of patients into groups patients n % Average age years Male 58 35,4% 64,1+4,5 Female 106 64,6% 68,3+3,9 The state of the autonomic nervous system was The following symptoms of VDS were revealed in assessed based on the characteristics of the initial elderly patients during the survey: headaches (HB) vegetative tone (IVT), autonomic reactivity (AR), - in 68.9%, esophageal dyskinesia (aerophagia, and autonomic support of activity (ASA). IVT and lump in the throat) - in 34.1%, gastric and AR allow us to judge the homeostatic capabilities intestinal dyskinesia (irritable bowel syndrome) - of the body, and ASA allows us to judge its adaptive in 64.6%, clino-orthostatic hypotension (COH) - in mechanisms. The initial vegetative tone (IVT) was 43.3%, neurogenic dysfunction of the bladder was assessed based on the Kerdo vegetative index (VI), in 23.8%, vestibulopathic syndrome (dizziness) - minute blood volume (MBV) (using the Lilje- in 24.4%, panic attacks - in 18.9%, local Strander method), and cardiointervalography hyperhidrosis - in 37.8%, angiotrophoneurosis (CIG) [4]. The assessment of the initial vegetative was rare in 9.1% of cases (t.2). tone (IVT) makes it possible to study the vegetative As for gender differences, it was found that the indices at relative rest (the balance of the frequency of vegetative complaints in women was parasympathetic and sympathetic influence of the more pronounced than in men. Reliably significant ANS). The tension index (TI) is a reflection of the differences were for such complaints as body's adaptation to pathology. Vagotonia was "esophageal dyskinesia (aerophagia, lump in the considered TI 90 c.u., TI > 160 c.u. - (irritable bowel syndrome)"; "neurogenic hypersympathicotonia (4). dysfunction of the bladder"; "panic attacks" and RESULTS "local hyperhidrosis" (Table 1). https://www.theamericanjournals.com/index.php/tajmspr 20 THE USA JOURNALS THE AMERICAN JOURNAL OF MEDICAL SCIENCES AND PHARMACEUTICAL RESEARCH (ISSN – 2689-1026) VOLUME 06 ISSUE11 In elderly patients with a vagotonic type in the (microsymptomatology) were observed with high anamnesis, pathology of the endocrine system was frequency in all forms of VDS. detected 1.5 times more often (p<0.05), frequent During a structural study of concomitant functional disorders of the gastrointestinal tract neurological pathologies, it was found that women (GIT), with the sympathicotonic type, dysfunctions more often develop markers of more complex of the cardiovascular system were recorded, neurological dysfunctions, including neurogenic frequent extrasystoles, tachycardia, mild dysfunction of the bladder (1.7 times), panic pathology of the central nervous system,