THE USA JOURNALS
THE AMERICAN JOURNAL OF MEDICAL SCIENCES AND PHARMACEUTICAL RESEARCH
(ISSN
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2689-1026)
VOLUME 06 ISSUE11
19
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PUBLISHED DATE: - 30-11-2024
https://doi.org/10.37547/TAJMSPR/Volume06Issue11-04
PAGE NO.: - 19-22
SPECTRUM OF AUTONOMIC NERVOUS
SYSTEM DISORDERS IN THE ELDERLY
DEPENDING ON GENDER
Ismigul ABBASOVA
Assistant of the Department of Neurology, Andijan, Uzbekistan
Janna NAZAROVA
Doctor of Medical Sciences, associate professor, Center for Development of
Professional Qualification of Medical Workers, Tashkent, Uzbekistan
INTRODUCTION
The diagnosis of “autonomic dysfunction
syndrome” (ADS) is not presented in ICD
-10. The
code G90
–
disorders of the autonomic nervous
system [1]
–
is used as an official diagnosis for
autonomic disorders. However, ADS is a disorder
that is common in the population. One of the most
common reasons for visiting primary care
physicians is severe physical symptoms, such as
heart pain or gastrointestinal disorders [4].
Moreover, every fifth visit to primary care is
associated with physical symptoms that physicians
cannot attribute to organic pathology or mental
disorder. These unexplained symptoms can range
from acute to chronic and from mild to severe, and
contribute significantly to individual disability and
the global burden of disease.
The syndrome of vegetative dysfunction is
currently considered as a comorbid pathology of
chronic cerebral ischemia, accompanying it as it
develops. With increasing age, the patient
experiences gradation of vegetative dysfunction.
Changes occurring in the vegetative nervous
system precede the neurological disorders that
arise subsequently and serve as a manifestation of
maladaptive reactions.
The aim of the study
. To identify the frequency
and nature of neurovegetative disorders
depending on gender in elderly people.
METHODS
The study included 163 elderly patients aged 60 to
74 years (average 67.2+6.8 years) with clinically
and laboratory confirmed stage 2 chronic cerebral
RESEARCH ARTICLE
Open Access
Abstract
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ischemia syndrome (CCIS2) and autonomic
dysfunction syndrome (ADS) (106 (64.4%)
women, 58 (35.6%) men). All patients were
hospitalized in the neurology department of the
Andijan State Medical Institute.
By gender, the patients were divided into 2 groups:
Group I consisted of men (58 patients), Group II
consisted of women (106 patients). The average
age of women was 68.3+3.9 years, and of men -
64.1+4.5 years. The control group (CG) consisted
of 20 patients who did not have clinical and
laboratory criteria for CCI and SVD, comparable in
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
assessed based on the characteristics of the initial
vegetative tone (IVT), autonomic reactivity (AR),
and autonomic support of activity (ASA). IVT and
AR allow us to judge the homeostatic capabilities
of the div, and ASA allows us to judge its adaptive
mechanisms. The initial vegetative tone (IVT) was
assessed based on the Kerdo vegetative index (VI),
minute blood volume (MBV) (using the Lilje-
Strander method), and cardiointervalography
(CIG) [4]. The assessment of the initial vegetative
tone (IVT) makes it possible to study the vegetative
indices at relative rest (the balance of the
parasympathetic and sympathetic influence of the
ANS). The tension index (TI) is a reflection of the
div's adaptation to pathology. Vagotonia was
considered TI < 30 c.u., eutonia - TI = 30-60 c.u.,
sympathicotonia - TI > 90 c.u., TI > 160 c.u. -
hypersympathicotonia (4).
RESULTS
The following symptoms of VDS were revealed in
elderly patients during the survey: headaches (HB)
- in 68.9%, esophageal dyskinesia (aerophagia,
lump in the throat) - in 34.1%, gastric and
intestinal dyskinesia (irritable bowel syndrome) -
in 64.6%, clino-orthostatic hypotension (COH) - in
43.3%, neurogenic dysfunction of the bladder was
in 23.8%, vestibulopathic syndrome (dizziness) -
in 24.4%, panic attacks - in 18.9%, local
hyperhidrosis - in 37.8%, angiotrophoneurosis
was rare in 9.1% of cases (t.2).
As for gender differences, it was found that the
frequency of vegetative complaints in women was
more pronounced than in men. Reliably significant
differences were for such complaints as
"esophageal dyskinesia (aerophagia, lump in the
throat)"; "stomach and intestinal dyskinesia
(irritable
bowel
syndrome)";
"neurogenic
dysfunction of the bladder"; "panic attacks" and
"local hyperhidrosis" (Table 1).
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In elderly patients with a vagotonic type in the
anamnesis, pathology of the endocrine system was
detected 1.5 times more often (p<0.05), frequent
functional disorders of the gastrointestinal tract
(GIT), with the sympathicotonic type, dysfunctions
of the cardiovascular system were recorded,
frequent
extrasystoles,
tachycardia,
mild
pathology of the central nervous system,
deviations
in
the
neurological
status
(microsymptomatology) were observed with high
frequency in all forms of VDS.
During a structural study of concomitant
neurological pathologies, it was found that women
more often develop markers of more complex
neurological dysfunctions, including neurogenic
dysfunction of the bladder (1.7 times), panic
attacks (2.3 times), p<0.05).
Table 2
Initial vegetative tone in elderly people with CCI II
Groups
Eytonia
Sympathicotonia
Vagotonia
n
%
n
%
n
%
мужчины n=58
5
8,6%
31
53,4%
22
37,9%
women n=106
10
9,4%
61
57,5%
35
33,0%
total
15
9,1%
92
56,1%
57
34,8%
The study revealed that the imbalance of
vegetative homeostasis was characteristic of the
majority of subjects
–
90.9% (n=149). The groups
had a small number of patients with eutonia, which
is a sign of the balance of regulatory
sympathoadrenal and cholinergic effects on the
div. In general, elderly patients had a
predominance of sympathicotonia compared to
vagotonia and normotonia
–
56.1%, 34.8% and
9.1%, respectively. Sympathicotonia indicates the
tension of adaptive-compensatory mechanisms in
the div.
In the studied groups, there was a reliably
significant difference in the number of patients
with sympathicotonia depending on gender. Thus,
sympathicotonia was detected in men - in 31
patients (53.4%), in 22 patients (37.9%) vagotonia
was observed, only 8.6% of patients had normal
vegetative tone (Table 2).
Among women, the sympathetic influence was also
predominant - in 61 (57.5%) patients,
parasympathicotonia was in 35 women (33.0%),
eutonia
in
10
(9.4%).
Patients
with
sympathicotonia predominated in the group of
women. In the group of men, patients with
parasympathetic
vegetative
tone
reliably
predominated (p<0.05).
CONCLUSIONS
Thus,
among elderly people,
autonomic
dysfunction occurs in 90.9% of cases, more often in
women. It should also be noted that features of
autonomic tone were found in elderly patients
with a predominance of hyperactivity of the
sympathetic autonomic nervous system. This
suggests that there is a high probability of failure
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of the div's adaptive capabilities. Given the high
degree of aggravation of various comorbid
conditions, we can talk about the risk of reducing
the functional reserves of the cardiovascular
system.
REFERENCES
1.
Аникина,
Е.А.
Распространенность,
факторы риска и клиническое течение
синдрома вегетативной дисфункции / Е.А.
Аникина, Н.М. Балабина // Сиб. мед. журн.
-
2011. -
Т. 102, № 3.
-
С. 23
-27.
2.
Антонюк
Т.
Нейроциркуляторная
дистония: патогенез, диагностика, лечение
//НЕЙРОNEWS, 2017.
-
№ 3(87).
-
С. 16
-18.
3.
Береславская,
Е.Б.
Вегетососудистая
дистония.
Современный
взгляд
на
профилактику
и
лечение
/
Е.Б.
Береславская.
-
СПб. : Весь, 2007.
-
160 с.
4.
Дёмин, A.B. Физическая интерпретация
вегетативного индекса Кердо / A.B. Дёмин,
А.И. Иванов // Образование. Наука. Науч.
кадры.
- 2013. -
№ 2.
-
С. 151
-156
