Электронный научный журнал

Itching in older patients is one of the most common and underestimated complaints, significantly affecting the quality of life, sleep, and the risk of developing anxiety and depressive disorders. Despite the high prevalence, standardized diagnostic and therapeutic approaches for people 65+ remain fragmented, which increases the importance of analyzing the evidence base. A focused narrative review was conducted with elements of systematic search in the PubMed/Medline, Cochrane, eLibrary, and CyberLeninka databases, as well as in the registers of clinical recommendations (EADV, RODVC) for the period from 2010 to 2025. Keywords used: pruritus, elderly, xerosis, neuro-immune, phototherapy, gabapentin, pregabalin, mirtazapine, difelikefalin, urea, NB-UVB, chronic pruritus guidelines. The review includes clinical recommendations, systematic reviews, randomized controlled trials (RCTs), and quasi-experimental studies focused on the dermatological causes of itching and xerosis in individuals 65+. The following interventions have the most proven effectiveness: barrier therapy using 5-10% urea for age-related xerosis; narrow-band medium-wave phototherapy (NB-UVB) for chronic itching of various etiologies; drugs of the gabapentin group (gabapentin, pregabalin) for the relief of neuropathic and refractory itching; Mirtazapine and some selective serotonin reuptake inhibitors (SSRIs) for central pruritus modulation; the k-opioid receptor agonist diphelifecalin in patients on dialysis. To achieve optimal results in patients 65+, a gerontologically adapted stepwise strategy is needed, taking into account polypragmasia, cognitive status, risk of falls, as well as liver and kidney function.