nnpNeurology, Neuropsychiatry, PsychosomaticsНеврология, нейропсихиатрия, психосоматика2074-27112310-1342"IMA-Press", LLC10.14412/2074-2711-2018-2-102-108nnp-893Research ArticleREVIEWSОБЗОРЫCurrent management tactics for patients with dementiaСовременная тактика ведения пациентов с деменциейМедведеваА. В.MedvedevaA. V.

Контакты: Анастасия Владимировна Медведева 

Кафедра нервных болезней и нейрохирургии 

119021, Москва, ул. Россолимо, 11

Contact: Anastasia Vladimirovna Medvedeva 

Department of Nervous System Diseases and Neurosurgery

11, Rossolimo St., Moscow 119021 

 

anastasia_medved@mail.ruКосивцоваО. В.KosivtsovaO. V.

Кафедра нервных болезней и нейрохирургии 

119021, Москва, ул. Россолимо, 11

Department of Nervous System Diseases and Neurosurgery

11, Rossolimo St., Moscow 119021 

МахиновК. А.MakhinovK. A.

Кафедра нервных болезней и нейрохирургии 

119021, Москва, ул. Россолимо, 11

Department of Nervous System Diseases and Neurosurgery

11, Rossolimo St., Moscow 119021 

ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова (Сеченовский университет)» Минздрава РоссииРоссияI.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of RussiaRussian Federation201824062018102102108Copyright © Medvedeva A.V., Kosivtsova O.V., Makhinov K.A., 20182018Медведева А.В., Косивцова О.В., Махинов К.А.Medvedeva A.V., Kosivtsova O.V., Makhinov K.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://nnp.ima-press.net/nnp/article/view/893

Dementia develops as a result of continuous long-term progression of less severe cognitive impairment (CI). Social and psychological methods (neurocognitive stimulation and neurocognitive training) are the mainstay of treatment for dementia. At the moment, there are no drugs both to cure dementia and to stop the degeneration of nerve tissue. Modern pharmacotherapy for dementia aims to maintain cognitive functions in the patient for as long as possible and to slow down disability, thus ensuring higher living standards. CI therapy most often consists of compensation for cognitive defect. Among the whole variety of pharmacological agents, the effective drugs to treat dementia are only two groups, such as acetylcholinesterase inhibitors and N-methyl-D-aspartate (NMDA) glutamate receptor antagonists. Atypical neuroleptics are employed for the treatment of psychotic disorders; antidepressants from a group of selective serotonin reuptake inhibitors are for depression. Cognitive behavioral therapy and cognitive stimulation deserve special attention. A high educational level and physical, social, and intellectual and activities can prevent dementia. 

Деменция формируется в результате длительного, многолетнего прогрессирования менее тяжелых когнитивных нарушений (КН). Основу лечения деменции составляют социальные и психологические методы (нейрокогнитивное стимулирование и нейрокогнитивный тренинг). В настоящий момент не существует препаратов, способных не только вылечить деменцию, но и остановить процесс дегенерации нервной ткани. Современная фармакотерапия деменции направлена на максимально долгое поддержание когнитивных функций пациента и замедление инвалидизации, обеспечивая тем самым более высокий уровень жизни. Терапия КН наиболее часто складывается из компенсации когнитивного дефекта. Среди всего многообразия фармакологических средств в отношении деменции эффективны препараты лишь двух групп – ингибиторы ацетилхолинэстеразы и антагонисты глутамат N-метилd-аспартат (NMDA)-рецепторов. При психотических расстройствах используются атипичные нейролептики, при депрессии – антидепрессанты из группы селективных ингибиторов обратного захвата серотонина. Особого внимания заслуживают когнитивно-поведенческая терапия и когнитивное стимулирование. Профилактике деменции способствуют высокий уровень образования пациента, физическая активность, активность в социальной и интеллектуальной сферах. 

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The authors declare that there are no conflicts of interest present.