An increase in the prevalence of insulin resistance in the elderly, associated with physiological changes in carbohydrate metabolism during the aging process, is associated with a high risk of cardiovascular accidents and endocrine diseases. This problem requires a solution by healthcare professionals with medication and non-medication. The purpose of the study was to determine the effectiveness of the program of physical therapy by the dynamics of indicators of the cardiovascular system, carbohydrate and lipid metabolism, psychoemotional status of elderly people with frailty and metabolic syndrome. Material and methods. 96 elderly people were examined. The control group consisted of persons without metabolic syndrome and without frailty. The main group 1 consisted of patients with metabolic syndrome and frailty with a low level of therapeutic alliance who did not want to cooperate with a physical therapist and / or actively improve their health on their own. The main group 2 included patients who agreed to undergo a developed program of physical therapy (a high level of therapeutic alliance) using kinesitherapy, massage, nutritional correction, education of the patient and his family, elements of cognitive training and occupational therapy for 1 year. The effectiveness of the program was assessed by the dynamics of systolic and diastolic blood pressure, heart rate, Kvass endurance coefficient, Baevsky's adaptive potential, Robinson's index, physical performance (based on the results of a 6-minute test), carbohydrate parameters (fasting blood glucose and after glucose load) and lipid (concentration of cholesterol, triglycerides, high density lipoproteins) metabolism, the level of depression according to the GDS-15 questionnaire. Results and discussion. In elderly people with frailty and metabolic syndrome, a statistically significant (p <0.05) deterioration in the parameters of the functioning of the cardiovascular system (according to the levels of DBP, heart rate at rest, Kvass endurance coefficient, Baevsky's adaptive potential, Robinson's index), physical performance (according to the results of a 6-minute test - distance, severity of fatigue, shortness of breath, cardialgia), biochemical parameters (fasting hyperglycemia, impaired glucose tolerance, atherogenic dyslipidemia), psycho-emotional state (depression) from their peers. The use of physical therapy tools led to a statistically significant improvement (p <0.05) of all the studied parameters of the functioning of the cardiovascular system, biochemical parameters in elderly people with metabolic syndrome and frailty, an increase in their physical performance, and an improvement in psycho-emotional status. A low level of therapeutic / rehabilitative alliance led to unsatisfactory fulfillment or non-fulfillment of the recommendations provided by patients and is associated with a lack of improvement in the state of the cardiovascular system, physical performance, age-associated depression. Conclusion. It is advisable to include physical therapy means in the rehabilitation programs for elderly patients with comorbid pathology like frailty and metabolic syndrome for the prevention of cardiovascular accidents

Keywords: rehabilitation, older age, obesity, insulin resistance, arterial hypertension

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