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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">10.14412/2074-2711-2025-3-84-91</article-id><article-id custom-type="elpub" pub-id-type="custom">nnp-2634</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>CLINICAL OBSERVATIONS</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКИЕ НАБЛЮДЕНИЯ</subject></subj-group></article-categories><title-group><article-title>Opportunities for differential diagnosis of vascular cognitive impairment and Alzheimer's disease at the predementia stage</article-title><trans-title-group xml:lang="ru"><trans-title>Возможности дифференциальной диагностики сосудистых когнитивных нарушений и болезни Альцгеймера на додементной стадии</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>Динара Александровна Гришина</p><p>119021, Москва, ул. Россолимо, 11, стр. 1</p></bio><bio xml:lang="en"><p>Dinara Aleksandrovna Grishina</p><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/0009-0002-9565-7429</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Метелкина</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Metelkina</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 государственный 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>2025</year></pub-date><pub-date pub-type="epub"><day>24</day><month>06</month><year>2025</year></pub-date><volume>17</volume><issue>3</issue><elocation-id>84–91</elocation-id><permissions><copyright-statement>Copyright &amp;#x00A9; Grishina D.A., Lokshina A.B., Metelkina E.A., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Гришина Д.А., Локшина А.Б., Метелкина Е.А.</copyright-holder><copyright-holder xml:lang="en">Grishina D.A., Lokshina A.B., Metelkina 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/2634">https://nnp.ima-press.net/nnp/article/view/2634</self-uri><abstract><p>The steadily increasing aging of the population is accompanied by a growing prevalence of cognitive impairment (CI) of varying severity. The main causes of CI are Alzheimer's disease (AD), vascular impairment, and their combination. It has been shown that establishing the exact etiology of CI is crucial for appropriate patient management and disease prognosis. The paper outlines current principles for the diagnosis and treatment of mild cognitive impairment (MCI) syndrome. It is demonstrated that the nosological structure of MCI generally corresponds to the etiology of dementia in the elderly. Early detection of CI at the MCI stage is important because timely diagnosis broadens the potential for secondary prevention and therapeutic intervention, which can delay or even prevent the onset of dementia.</p><p>A clinical observation is presented of a female patient with a polyfunctional amnestic type of MCI syndrome, with both vascular and neurodegenerative mechanisms considered as potential etiological factors. Examination of the cerebrospinal fluid revealed biomarkers of AD, which enabled a diagnosis of late-onset AD at the predementia stage. The paper also analyzes the capabilities of modern neuroprotective and symptomatic therapies for CI, and the role of choline alfoscerate and citicoline in CI treatment.</p><p>he discussion includes ways to improve patient adherence to CI treatment using newly available dosage forms such as Noocil (240 ml bottle, oral liquid form of citicoline) and Cerpehol (240 ml bottle, oral liquid form of choline alfoscerate), which can also be used in patients with swallowing difficulties.</p></abstract><trans-abstract xml:lang="ru"><p>Нарастающая с каждым годом тенденция к постарению населения сопровождается ростом распространенности когнитивных нарушений (КН) разной степени тяжести. Основными причинами КН являются болезнь Альцгеймера (БА), сосудистые наршения и их сочетание. Показано, что установление точной причины КН имеет большое значение для правильного ведения пациентов и прогноза заболевания. Приведены современные принципы диагностики и лечения синдрома умеренных КН (УКН). Показано, что нозологическая структура УКН в целом соответствует этиологии деменции в пожилом возрасте. Важность раннего выявления КН на стадии УКН обусловлена тем, что своевременная диагностика этих расстройств расширяет потенциальные возможности вторичной профилактики и терапевтического воздействия, что может отсрочить или даже предотвратить наступление деменции. Представлено наблюдение пациентки с полифункциональным амнестическим типом синдрома УКН, в этиологии которого можно обсуждать как сосудистые, так и нейродегенеративные механизмы. При исследовании цереброспинальной жидкости обнаружены биомаркеры БА, что позволило поставить диагноз БА с поздним началом на додементной стадии. Анализируются возможности современной нейропротективной и симптоматической терапии КН, место холина альфосцерата и цитиколина в лечении КН. Обсуждаются вопросы повышения приверженности пациентов лечению КН путем назначения новой удобной формы выпуска препаратов Нооцил (флакон 240 мл, жидкая форма цитиколина для приема внутрь) и Церпехол (флакон 240 мл, жидкая форма холина альфосцерата для приема внутрь), данные формы также могут использоваться при нарушениях глотания.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>когнитивные нарушения</kwd><kwd>умеренные когнитивные нарушения</kwd><kwd>болезнь Альцгеймера</kwd><kwd>сосудистые когнитивные нарушения</kwd><kwd>холина альфосцерат</kwd><kwd>цитиколин</kwd><kwd>Церпехол</kwd><kwd>Нооцил</kwd></kwd-group><kwd-group xml:lang="en"><kwd>cognitive impairment</kwd><kwd>mild cognitive impairment</kwd><kwd>Alzheimer's disease</kwd><kwd>vascular cognitive impairment</kwd><kwd>choline alfoscerate</kwd><kwd>citicoline</kwd><kwd>Cerpehol</kwd><kwd>Noocil</kwd></kwd-group><funding-group><funding-statement xml:lang="ru">Статья спонсируется компанией «Озон».</funding-statement><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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