Vol 22, No 1 (2026)

Disability is a key indicator of public health, as it reflects high morbidity rates, low life expectancy, high mortality, and poor quality of life among the population. This article presents the results of the study on the dynamics of the number and structure of adult populations in Moscow who were first recognized as disabled (FRD) due to diseases classified as socially significant. The study includes FRD cases resulting from: malignant neoplasms (MN); diabetes mellitus (DM); mental and behavioural disorders (MBD), diseases characterized by high blood pressure (HBP). The study period covered the years 2010–2023. The MN cohort had the highest proportion of Group I and Group II disabled individuals, collectively accounting for 76,1 %. Among FRD cases due to DM and HBP Group III disability was predominantly assigned. The disability structure in the MBD cohort was mixed. Group III disabled individuals predominated; however, the proportion of Group I disabled individuals was high (32,4 %). In all studied cohorts, the proportion of older disabled individuals was dominant. Specifically, among FRD cases due to HBP, older individuals accounted for 75 % of all cases. To effectively implement a strategy aimed at preventing primary disability caused by socially significant diseases, a comprehensive approach is required. Key directions for addressing this pressing medical and social issue include reducing the prevalence of modifiable risk factors, early detection and prevention of chronic non communicable diseases, strengthening preventive infrastructure, implementing modern treatment and rehabilitation technologies. These measures will help reduce the incidence of disabling complications.

The article presents regional data on gender, age, and nosological structure and dynamics of newly identified disability (NID) of over working age population in Lipetsk region in 2020–2024. During the study period, the NID contingent among the adult population of the region was characterized by decrease the total number of people with disabilities, with a predominance of disabled people of retirement age — 100.4 ± 8.6 per 10,000 population. For people of working age this indicator was 36.5 ± 0.4 per 10,000 population (p < 0.05). Prevalence of group III disabled people has been established by more than 2 times (27.5 ± 1.9 per 10,000 population) with an annual growth tendency. 55.4 % of them are of working age. There are 1.5 times more men than women in the gender structure of disability (73.8 ± 4.2 per 10,000 for men and 49.2 ± 3.6 for women, p < 0.05). At retirement age, NID level increases 3.7 times in men, 3 times in women. Nosological structure of disability coincides with the data for Russian Federation and Central Federal District: malignant neoplasms, circulatory system and musculoskeletal system diseases are the most common.

This article presents the results of a comparative analysis of adult disability due to colorectal cancer in the Russian Federation, the Central Federal District, and Moscow over a long-term observation period, from 2018 to 2023. Analysis of disability rates due to colorectal cancer revealed a consistent trend of increasing disability prevalence at the regional level: in the Russian Federation, the Central Federal District, and Moscow, as well as an increase in the prevalence of all types of disability: primary, recurrent, and general. A demographic analysis of disability by age revealed that in all regions, including the Russian Federation, the Central Federal District, and Moscow, the largest proportion were individuals of over the working age (55 years and older for women and 60 years and older for men). In the gender structure of disability due to colorectal cancer in the Russian Federation, the Central Federal District, and Moscow, women made up the largest proportion. Statistically significant medical and social differences were found in the structure of disability groups for primary and recurrent disability due to colorectal cancer. Although severely disabled individuals with Groups I and II predominated at all territorial levels, Group II disabled individuals ranked first in the primary disability structure, Group I disabled individuals ranked second, and Group III disabled individuals ranked third. Group II disabled individuals also ranked first in the recurrent disability structure, but Group III disabled individuals ranked second, and Group I disabled individuals ranked third. This justified organizational considerations in the development of rehabilitation measures and services.

Introduction. After radical treatment for colorectal cancer (CRC), some patients continue to experience functional limitations and psychosocial distress, which necessitates profile-oriented rather than uniform rehabilitation programs. Aim. To identify target rehabilitation groups based on the combination of functional status and psychosocial well-being and to describe recovery trajectories over a 6-month period. Methodology. A single-center observational clinical and functional study was conducted at oncology inpatient facilities in Moscow between 2018 and 2023. From the initial cohort of patients with CRC (n = 623), an analytical sample of 104 patients was formed. Assessments were performed after completion of cancer-specific treatment (T0) and at 6 months (T6). The Karnofsky Performance Status (KPS), the SF-36 questionnaire (Physical Component Summary [PCS] and Mental Component Summary [MCS]), the Hospital Anxiety and Depression Scale (HADS), indicators of social support, and employment status were used. Stratification was performed using threshold values of KPS = 80 and MCS = 50, resulting in four profiles based on the combination of physical and mental health status. Results. Groups I–IV included 29 (27.9%), 25 (24.0%), 27 (26.0%), and 23 (22.1%) patients, respectively. Profiles II and IV were characterized by higher levels of distress (HADS ≥ 11: 44.0 % and 52.2 %) and more frequent deficits in social support. At 6 months, KPS and PCS increased in all profiles; the greatest improvement in PCS was observed in profiles III and IV (ΔPCS +24.4 and +19.7). Improvements in MCS were most pronounced in profiles II and IV (ΔMCS +15.2 and +20.1). Return-to-work rates at 6 months were 75.9 %, 52.0 %, 37.0 %, and 26.1 %, respectively. Scientific novelty. Simple stratification based on KPS and MCS identifies clinically and socially distinct profiles with different recovery trajectories. Practical significance. The proposed model can be applied during the initial rehabilitation consultation to select priority rehabilitation modules and to identify high-risk groups at an early stage.

Introduction. The increasing incidence and mortality of cancer, along with the growing contribution of hereditary malignancies, necessitate the implementation of personalized prevention models based on molecular genetic risk stratification and early cancer detection among asymptomatic carriers of highly penetrant germline mutations. Aim. The aim of this study was to evaluate the clinical and economic effectiveness of early cancer detection programs based on molecular genetic testing and structured surveillance of high-risk populations. Methodology. The economic evaluation was conducted using cost-benefit analysis (CBA) from a societal perspective and included direct medical and non-medical costs as well as indirect losses associated with productivity loss and premature mortality. Two scenarios were modeled: molecular genetic testing at program entry followed by structured surveillance with predominantly early-stage cancer detection, and the absence of genetic testing and systematic surveillance resulting in a higher proportion of late-stage diagnoses. The analysis was based on registry data from 554 carriers of germline mutations enrolled between 2018 and June 2024; during the observation period, 56 cases of breast cancer were identified, predominantly at stages I – II. Modeling was performed over a five-year time horizon with adjustment for projected inflation and discounting of societal costs. Results. The total societal cost per patient under the early detection scenario amounted to RUB 1.736.702, compared with RUB 2.980.342 in the absence of genetic testing and surveillance, resulting in cost savings of RUB 1.243.640 per patient and approximately RUB 70 million for the entire cohort of detected cases. Practical significance. The findings demonstrate the high economic efficiency of genetic testing and surveillance programs for high-risk populations and support their implementation as an effective tool for optimizing cancer care and reducing overall societal costs.

The article presents the results of fundamental research on the problems of brain neuroplasticity and human cognitive abilities in the context of neurosensory hearing impairments. The article analyzes promising ways to find the necessary tools and methods for using neuroplasticity to normalize the conditions of inclusive education and training of highly qualified specialists among hearing-impaired individuals. The article describes the cognitive auditory-speech processes and communication difficulties for this category of students, which become critically problematic and require special solutions to normalize them. These solutions lie in the systematic integration of a complex of cognitive, digital, and assistive technologies into a specialized information and educational environment, resulting in successful comprehensive rehabilitation of hearing-impaired university students.