Background: Falls and frailty are associated geriatric syndromes. Knowing the features of falls in patients with different functional status will make it possible to personalize the fall prevention and reduce the progression of frailty.

Aim: To characterise falls in older depending on geriatric status (robust, prefrailty and frailty).

Materials and methods: Included 1002 patients (77,5±8,2) hospitalized in the geriatric department. The frailty was screened on the scale «Age Not Interference». With the score 1–2, frailty was not diagnosed. With the score 3 or more, comprehensive geriatric assessment was carried out and 2 more groups were allocated: with prefrailty (n=199, 19.9%) and with frailty (n=482,48.1%). All patients found out the fact of falls during the year, if there was, they were characterized by falls. To analyze the effect of falls on functional status, it was evaluated in patients with frailty and falls and frailty without falls.

Results: With increasing severity of geriatric status, the prevalence of falls increased, reaching 57% in patients with frailty. 63.7% previously noted falls, 44.7% formed a fear of falls. One in 10 falls resulted in a serious consequence, which caused hospitalization. The risk of falls increased depending on geriatric deficiency: patients with frailty at high risk were 2 times greater compared to robust patients. The findings demonstrate that patients with frailty undergoing falls compared to patients without falls.

In patients with frailty and falls, compared to patients without falls, despite younger age and lower comorbidity, functional status was worse. They had a significantly lower score on the MNA, higher score on the PHQ-9 and anxiety score, and performed the chair stand longer. Multivariate analysis showed that a reduction in the sum of the SPPB by 0.35 and the PHQ-9 scale by 0.77, an increase in SARC-F by 0.68 and a time of performance of the chair stand by 3.39 seconds is associated with a fall in older people with frailty adjusted for age and comorbidity.

Conclusion: Frailty is a conditionally reversible syndrome, and falls is often prevented. Considering the identified features of falls in patients with reduced functioning will allow individualizing the fall prevention plan.

Background. The organization of screening for osteoporosis is an actual problem due to the need for early detection of patients with high risk of fractures and initiation of their treatment.

Aim. The aim of our study was to study the effectiveness of screening for osteoporosis (high risk of fractures) in postmenopausal men and women 40 years and older.

Materials and methods. Screening was performed by outpatient doctors for all people aged 40 years and older who applied for various reasons. The doctor asked standard questions included in the FRAX questionnaire.

Results. In 2017– 2020, 11,013 people were screened by outpatient doctors — 31.7% of the total attached population aged 40 years and older. According to the screening results, 21.9% people were identified with a high risk of fractures. The average 10-year probability of major osteoporotic fractures in these patients (19.0±7.9%) was statistically significantly higher compared to the rest of the screened (7.6±3.3%), p=0.0001. 60% (1,450 people) of the group of individuals with an identified high risk of fractures were patients with FRAX in the area of therapeutic intervention. Among them were patients with indications of a fracture and without a history of fractures. In the remaining 40%, the high risk was determined only on the basis of the fact of a previously suffered fracture (their FRAX index was below the intervention threshold). In general, using only the FRAX calculator, 40 men and 1410 women were identified as having a high risk of fractures, which accounted for 1.3% of the male and 17.7% of  the female screened population, respectively. With the simultaneous use of FRAX and anamnestic data on a previous fracture, 13.3% of men and 25.3% of women in the screening population had a high risk of fractures.

Conclusion. Screening in primary health care has allowed us to identify 21.9% of the screened population of men and women aged 40 years and older (postmenopausal women) as having a high risk of fractures. Screening with simultaneous calculation of the 10-year risk of fractures according to FRAX and clarification of the presence of a history of fractures was the most effective.

Hyperparathyroidism is a clinical and laboratory syndrome characterized by hyperproduction of parathyroid hormone (PTH) by cells of the parathyroid glands (PTG) and is subdivided, depending on the cause of its occurrence, into primary (PHPT), secondary (SHPT) and tertiary hyperparathyroidism (THPT). To date, only a few scientific papers have been published on the features of the relationship between vitamin D and various forms of hyperparathyroidism, there may be several reasons for this. First, this is due to the fact that the true prevalence of vitamin D deficiency in hyperparathyroidism is unknown. Secondly, difficulties in the differential diagnosis of hyperparathyroidism sometimes entail not always justified surgical intervention with the potential development of complications, which, of course, is a rather narrow area of interest, both in endocrinology in particular and in medicine in general. Thirdly, the asymptomatic, often hidden, latent nature of the variety of multiple organ clinical manifestations of hyperparathyroidism, in combination with low levels of 25(OH)D, as the disease progresses, can lead to a significant decrease in the quality and life expectancy of patients. The combination of these arguments prompted us to summarize all the data available to date on the complexity of the relationship between vitamin D and various forms of hyperparathyroidism.

The article presents current data on mineral and bone disorders in patients with various stages of chronic kidney disease. The key points of bone lesions pathology are reflected, which include impaired secretion of parathyroid hormone and phosphorus-calcium metabolism, specific osteopathy and extraskeletal calcification, the relationship between bone pathology and cardiovascular complications is indicated. The role of diagnostic tools (FRAX questionnaire, bone densitometry, biochemical parameters and new biological markers) is discussed, approaches to the interpretation of research results are defined. Both general population and specific risk factors for bone strength decrease and occurrence of osteoporotic fractures pathology in chronic kidney disease are described.