Электронный научный журнал

This narrative review addresses the role of geriatric medicine as a key component of a healthy and active longevity strategy, focusing on excess body weight in older adults as a peptide mediated metabolic disorder. The article emphasizes that Russia and Eastern European countries are characterized by a “metabolic” pattern of ageing, with high prevalence of overweight and obesity in older age groups, superimposed on age related muscle loss and leading to a sarcopenic obesity phenotype. Current evidence on the pathophysiology of obesity in later life is summarized, highlighting the contribution of insulin resistance, leptin resistance, and dysregulation of ghrelin and gut incretins (GLP 1, PYY, etc.) to sustained positive energy balance, visceral and ectopic fat accumulation, and progression of systemic metabolic impairment. Geriatric oriented approaches to diagnosis (comprehensive geriatric assessment, identification of sarcopenic obesity), prevention and treatment are discussed, including dietary and lifestyle modification, structured resistance training programmes and the rational use of peptide targeted pharmacotherapy (GLP 1 receptor agonists and others). The review concludes that excess body weight in older adults should be regarded as a modifiable peptide metabolic target and that integration of these strategies into geriatric practice is essential for the development of evidence based Longevity Medicine.