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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">nnp</journal-id><journal-title-group><journal-title xml:lang="en">Neurology, Neuropsychiatry, Psychosomatics</journal-title><trans-title-group xml:lang="ru"><trans-title>Неврология, нейропсихиатрия, психосоматика</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2074-2711</issn><issn pub-type="epub">2310-1342</issn><publisher><publisher-name>"IMA-Press", LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.14412/2074-2711-2024-6-118-124</article-id><article-id custom-type="elpub" pub-id-type="custom">nnp-2428</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEWS</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОРЫ</subject></subj-group></article-categories><title-group><article-title>Management of patients with cognitive impairment in old age</article-title><trans-title-group xml:lang="ru"><trans-title>Ведение пациентов с когнитивными нарушениями в пожилом возрасте</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2424-3245</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Гришина</surname><given-names>Д. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Grishina</surname><given-names>D. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p> 119021, Москва, ул. Россолимо, 11, стр. 1 </p></bio><bio xml:lang="en"><p> 11, Rossolimo St., Build. 1, Moscow 119021 </p></bio><email xlink:type="simple">dstepkina@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9467-6244</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Локшина</surname><given-names>А. Б.</given-names></name><name name-style="western" xml:lang="en"><surname>Lokshina</surname><given-names>A. B.</given-names></name></name-alternatives><bio xml:lang="ru"><p> 119021, Москва, ул. Россолимо, 11, стр. 1 </p></bio><bio xml:lang="en"><p> 11, Rossolimo St., Build. 1, Moscow 119021 </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0004-6495-4249</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Соколов</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Sokolov</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p> 119021, Москва, ул. Россолимо, 11, стр. 1 </p></bio><bio xml:lang="en"><p> 11, Rossolimo St., Build. 1, Moscow 119021 </p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Кафедра нервных болезней и нейрохирургии Института клинической медицины им. Н.В. Склифосовского ФГАОУ ВО «Первый Московский медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет)</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Department of Nervous Diseases and Neurosurgery, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2024</year></pub-date><pub-date pub-type="epub"><day>18</day><month>12</month><year>2024</year></pub-date><volume>16</volume><issue>6</issue><elocation-id>118–124</elocation-id><permissions><copyright-statement>Copyright &amp;#x00A9; Grishina D.A., Lokshina A.B., Sokolov E.A., 2024</copyright-statement><copyright-year>2024</copyright-year><copyright-holder xml:lang="ru">Гришина Д.А., Локшина А.Б., Соколов Е.А.</copyright-holder><copyright-holder xml:lang="en">Grishina D.A., Lokshina A.B., Sokolov E.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://nnp.ima-press.net/nnp/article/view/2428">https://nnp.ima-press.net/nnp/article/view/2428</self-uri><abstract><p>Cognitive impairment (CI) is one of the most common disorders in elderly. As the population ages, the prevalence of cognitive impairment CI is also increasing. The importance of early identification of individuals with mild CI (MCI) lies in the fact that timely diagnosis of these disorders increases the potential for secondary prevention and therapeutic intervention, which can delay or even prevent the onset of occupational and social maladaptation due to the development of dementia. The current principles of classification of the MCI and the criteria for its diagnosis are presented. Current approaches to the treatment of patients with CI are discussed. It is shown that treatment should start as early as possible and include both non-pharmacological and pharmacological approaches to improve cognitive abilities and prevent CI progression. The possibilities of modern neuroprotective and symptomatic therapy of MCI and the role of choline alfoscerate in the treatment of MCI and dementia are presented. The results of the multicenter placebo-controlled ASCOMALVA study are discussed, in which the addition of choline alfoscerate to donepezil therapy in patients with Alzheimer's disease and cerebrovascular disease helped to slow the progression of CI, reduce the severity of the disease, and had a positive effect on the behavioral functions and emotional status of both patients and their caregivers. In addition, a decrease in the progression of cerebral atrophy was observed. A new form of choline alfoscerate (Cerpechol) for oral administration is reported that may increase patients' compliance and can be used in patients with dysphagia.</p></abstract><trans-abstract xml:lang="ru"><p>Нарушения когнитивных функций (КФ) являются одним из наиболее частых расстройств в пожилом и старческом возрасте. Учитывая нарастающую с каждым годом тенденцию к постарению населения, растет и распространенность когнитивных нарушений (КН). Важность раннего выявления лиц с умеренными КН (УКН) обусловлена тем, что своевременная диагностика этих расстройств расширяет потенциальные возможности вторичной профилактики и терапевтического воздействия, которое может отсрочить или даже предотвратить наступление профессиональной и социальной дезадаптации из-за развития деменции. Приведены современные принципы классификации синдрома УКН и критерии его диагностики. Обсуждаются современные подходы к ведению пациентов с КН. Показано, что лечение должно начинаться как можно раньше и включать как немедикаментозные, так и медикаментозные подходы, направленные на улучшение КФ, а также профилактику прогрессирования КН. Показаны возможности современной нейропротекторной и симптоматической терапии КН, место холина альфосцерата в лечении УКН и деменции. Обсуждаются результаты многоцентрового плацебоконтролируемого исследования ASCOMALVA, в котором у пациентов с болезнью Альцгеймера и цереброваскулярным заболеванием присоединение холина альфосцерата к терапии донепезилом способствовало замедлению прогрессирования КН, уменьшало их выраженность, а также положительно влияло на поведенческие функции и эмоциональный статус как пациентов, так и ухаживающих за ними лиц. Кроме того, было отмечено уменьшение прогрессирования атрофии головного мозга. Сообщается о новой форме холина альфосцерата (Церпехол) для приема внутрь, которая может повысить приверженность пациентов лечению и использоваться при нарушениях глотания.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>когнитивные нарушения</kwd><kwd>умеренные когнитивные нарушения</kwd><kwd>деменция</kwd><kwd>холина альфосцерат</kwd><kwd>Церпехол</kwd></kwd-group><kwd-group xml:lang="en"><kwd>cognitive impairment</kwd><kwd>mild cognitive impairment</kwd><kwd>dementia</kwd><kwd>choline alfoscerate</kwd><kwd>Cerpechol</kwd></kwd-group><funding-group><funding-statement xml:lang="en">The article is sponsored by Ozon</funding-statement></funding-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">GBD 2019 Dementia Forecasting Collaborators. 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