The Long Summer: how is the approach to working with elderly patients changing?
Since September 1, a new specialty has appeared in Russia — a doctor in the field of healthy longevity medicine. It is assumed that he will work with age-related patients "ahead of the curve", identifying risk factors in the early stages, before the development of the disease. Against the background of the gradual aging of the population, the country is increasingly relying on preventive and preventive measures. Izvestia talked with geriatric doctors about how the approach to the health of the elderly is changing today and how this is reflected in medicine.
Manageable old age
Since September 1, 2026, a new specialty has officially appeared in Russia — a doctor in the field of healthy longevity medicine.
"Unlike a geriatrician, he must work with conditionally healthy people, identifying early changes and factors of future diseases," Olga Tkacheva, chief freelance geriatrician at the Ministry of Health, corresponding member of the Russian Academy of Sciences, director of the Russian Gerontological Research and Clinical Center (RGNC), explained to Izvestia.
The innovation continues the trend of recent years towards the development of preventive measures aimed at maximizing the activity of older people in their mature years. Previously, the format of healthy longevity medicine centers had already been introduced in Russia. In August 2026, Deputy Prime Minister Tatyana Golikova said that they operate in 72 regions of the Russian Federation.
These measures are being taken against the background of global population aging. According to WHO, from 2000 to 2019, global life expectancy increased by 6.4 years, and healthy life expectancy increased by 5.3 years.
According to estimates by Mikhail Murashko, the head of the Ministry of Health, announced in the fall of 2025, by 2030 the number of Russians over the age of 60 will amount to about a third of the total number of citizens of the country. In October 2023, according to his own estimates, this figure was about 23.5%.
At the same time, not only the rate of aging is changing, but also the life of society as a whole, which also affects the final figures. So, for several decades, the biological nature of aging has not changed, but the conditions in which it takes place have changed, Olga Tkacheva told Izvestia.
— Thanks to the achievements of clinical medicine, people are less likely to die prematurely and more likely to live to old age. However, an increase in life expectancy has not yet been accompanied by an equally rapid increase in healthy life expectancy," the source noted. — Therefore, it is more correct to say that old age has become more prolonged and manageable, but not necessarily easier. Although we have already started working on solving this problem.
According to the expert, there are no fundamentally new age-related diseases, but against the background of increasing life expectancy in the modern world, the number of people with dementia, diabetes, cancer and diseases of the musculoskeletal system has increased significantly.
— This is due to the fact that more people live to an age when the risk of such conditions is particularly high, and also with lifestyle — we began to move less against the background of higher availability of food. More accurate diagnosis and an increase in life expectancy after diagnosis also have an impact," Olga Tkacheva noted.
For example, according to WHO, the global burden of diabetes and Alzheimer's disease has more than doubled from 2000 to 2021, but this does not mean that today's elderly people suffer from them much more often than their peers in the past. It must be borne in mind that over the years, the availability of medicine and diagnostic capabilities have increased significantly. several times, the editorial interlocutor explained.
The danger of chronic stress
Today, aging occurs in more favorable conditions compared to the middle of the 20th century, agrees Igor Lastochkin, a geriatrician at the Scientific and Practical Gerontopsychiatric Center (NPGTS) of the Department of Labor and Social Protection of the Population of Moscow.
— The so-called "late adulthood" phase has become significantly longer. The emphasis is shifted to active longevity: various programs for the elderly are being developed, for example, in the capital, Moscow Longevity, a system for the prevention and early diagnosis of diseases, personalized medicine and rehabilitation," the specialist recalled.
At the same time, the modern rhythm of life also brings "aggravating factors": chronic stress, information overload, physical inactivity, irregular sleep, and not always a balanced diet, the geriatrician listed.
— Chronic stress, for example, can lead to dementia and cognitive disorders. Excess calories and decreased physical activity lead to obesity and osteoarthritis, as well as type 2 diabetes. Smoking and poor nutrition can cause cardiovascular diseases," he recalled.
Many diseases that were previously considered incurable are now successfully controlled, in particular, hypertension, diabetes, and some forms of oncology, Igor Lastochkin added.
But due to the increase in life expectancy, older people may accumulate several chronic diseases at the same time. This complicates the clinical picture: one disease can worsen another, and treatment requires a comprehensive approach, the source explains.
Who is a geriatrician?
Today, the main specialists who work with age—related patients are geriatricians. They practice an integrated approach to the health of the elderly, taking into account individual characteristics, explained Igor Lastochkin.
— The specialist evaluates the condition of the body as a whole: it takes into account the interaction of several chronic diseases, side effects of medications, and the patient's functional capabilities, — he said. — Develops an individual treatment plan, minimizing excessive prescribing of medications. Prevents the typical problems of aging: falls, pressure sores, loss of muscle mass, cognitive impairment.
In addition, specialists in this field help to maintain independence by selecting rehabilitation products, advising on nutrition and physical activity, and coordinating assistance with other specialists, the expert added. All this helps to maintain the quality of life of an elderly patient.
Contacting a geriatrician is not necessary for everyone, but it is recommended if the quality of life suffers due to diseases, Igor Lastochkin emphasized.
"People aged 75+ should consult a specialist, even in the absence of obvious complaints, as the risk of multiple diseases increases," the source said.
Other indications for going to the geriatrician include the presence of two or more chronic diseases (for example, diabetes, hypertension, arthritis), severe illnesses requiring long—term rehabilitation, such as stroke, heart attack or fractures, as well as difficulties with movement, self-care, memory and spatial orientation, or frequent hospitalization, the doctor said.
He also noted that since 2023, Russia's first Simulation Center for Professional Care Skills Training has been operating on the basis of the NPGTS, where relatives of seriously ill elderly people can practice complex manipulations on high-tech simulators and mannequins.
An integrated approach
Currently, there are 85 geriatric centers in Russia, and about 2,000 geriatric doctors provide care to the elderly. This is an already established federal network, but the availability of such assistance in the regions still varies. At the same time, the need for geriatricians will only grow, Olga Tkacheva warned.
— When we first started, many students did not even know about the existence of geriatrics. Now the situation has changed dramatically, which is encouraging," she said.
The global change in the demographic situation around the world inevitably increases the burden on the medical care system, the source said.
— After all, the burden on a doctor is determined not only by the number of patients, but also by the complexity of their condition. An elderly person often needs to treat several diseases at the same time, it is also necessary to evaluate the compatibility of medications and take into account changes in memory, nutrition, mobility and the ability to cope with everyday tasks," said the chief freelance geriatrician of the Ministry of Health.
Despite the emergence and development of specialized specialties, it is necessary to understand that working with age-related patients involves an integrated approach, the expert emphasized.
According to her, an important aspect remains the training of primary care physicians in the basics of managing elderly patients, since one specialized specialist will not be able to take on the entire burden associated with the aging population.
— The medicine of healthy longevity will require a general change in the work of the entire primary sector. The key role will remain with the therapist and the general practitioner, who should identify the risks of developing geriatric problems as early as possible and coordinate treatment and long—term follow-up," Olga Tkacheva said.
At the same time, the importance of medical rehabilitation, neurogeriatrics, clinical pharmacology of the elderly and other specialties will grow.
— Healthy longevity cannot be ensured by the efforts of one specialist: it requires teamwork, in which prevention, treatment, rehabilitation and social support are interconnected," the Izvestia interlocutor summed up.
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