Current therapy for cognitive impairments
Abstract
Cognitive impairments (CIs) are a highly common type of neurological disorders particularly in elderly patients. Choice of a therapeutic strategy for CI is determined by the etiology of abnormalities and their degree. Measures to prevent CI progression and dementia: adequate treatment of existing cardiovascular diseases, prevention of stroke, balanced nutrition, moderate physical and intellectual exercises, and combatting overweight and low activity are of basic value in treating mild and moderate CIs. According to the data of a number of investigations, the above measures reduce the risk of dementia, including in the genetically predisposed. Pharmacotherapy for mild and moderate CIs generally comprises vasoactive, neurometabolic, and noradrenergic agents. The indication for the use of memantine and/or acetylcholinergic agents, i.e. basic therapy for the most common forms of dementia (Alzheimer's disease, Lewy body dementia, vascular, and mixed dementia), hepatic colics is severe CIs. The long-term use of memantine and/or acetylcholinergic agents alleviates the cognitive and behavioral symptoms of dementia, enhances self-dependence in patients, and prolongs their active lifetime.
About the Author
N. V. Vakhnina
I.M. Sechenov First Moscow State Medical University
Russian Federation
Department of Nervous Diseases
Russian Federation
Department of Nervous Diseases
References
1. <div><p>Яхно Н.Н. Когнитивные расстройства в неврологической клинике. Неврол журн 2006;11(прил. 1):4–12.</p><p>Яхно Н.Н., Захаров В.В. Легкие когнитивные расстройства в пожилом возрасте. Неврол журн 2004;9(1):4–8.</p><p>Яхно Н.Н., Локшина А.Б., Захаров В.В. Легкие и умеренные когнитивные расстройства при дисциркуляторной энцефалопатии. Неврол журн 2004;2:30–5.</p><p>Яхно Н.Н., Захаров В.В., Локшина А.Б. Синдром умеренных когнитивных нарушений при дисциркуляторной энцефалопатии. Журн неврол и психиатр 2005;105(2):13–7.</p><p>DiCarlo A., Baldereschi M., Amaducci L. et al. Cognitive impairment without dementia in older people: prevalence, vascular risk factors, impact on disability. The Italian Longitudinal Study on Aging. J Am Ger Soc 2000;48:775–82.</p><p>Graham J.E., Rockwood K., Beattie E.L. et al. Prevalence and severity of cognitive impairment with and without dementia in an elderly population. Lancet 1997;349:1793–6.</p><p>Болезнь Альцгеймера и сосудистая деменция. Под ред. Н.Н. Яхно. М., 2002;85 с.www.mocatest.org</p><p>Skoog I., Gustafson D. Clinical trials for primary prevention in dementia. In: Dementia therapeutic research. K. Rockwood, S. Gauthier (eds). London a New York: Taylor a Francis, 2006;189–212.</p><p>Rockwood K., Kirkland S., Hogan D.B. Use of lipid-lowering agents, indication bias and the risk of dementia in community-dwelling elderly people. Arch Neurol 2002;59:223–7.</p><p>Pendlebury S.T., Rothwell P.M. Prevalence, incidence and factors associated with prestrike and post-stroke dementia: a systematic review and meta-analysis. Lancet Neurol 2009;8(11):1006–18.</p><p>Климов Л.В., Парфенов В.А. Когнитивные нарушения в остром периоде ишемического инсульта. Неврол журн 2006;11(прил.1):53–6.</p><p>Парфенов В.А., Вахнина Н.В., Никитина Л.Ю. Когнитивные нарушения после инсульта и их лечение мемантином. Клин геронтол 2005;11(8):49–52.</p><p>Olazaran J., Muniz R., Reisberg B. et al. Benefit of cognitive-motor intervention in MCI and mild-to-moderate AD. Neurology 2004;63(12):2348–53.</p><p>Rapp S., Brenes G., Marsh A.P. Memory enhancement training for older adults with mild cognitive impairment: a preliminary study. Aging and mental health 2002;6(1):5–11.</p><p>Smidt I.W., Berg I.G., Deelman B.G. Memory training for remembering names: initial results in the healthy elderly. Tijdchr Gerontol Geriatr 1997;28(4):155–62.</p><p>Abbott R.D., White R.D., Ross G.W. et al. Walking and dementia in physically capable elderly men. JAMA 2004;292(12):1447–53.</p><p>Laurin D., Verreault R., Linsay J. et al. Physical activity and risk of cognitive impairment and dementia in elderly persons. Arch Neurol 2001;58(3):498–504.</p><p>Rovio S., Kareholt I., Helkala E.L. et al. Leisure-time physical activity at midlife and the risk of dementia and Alzheimer’s disease. Lancet Neurol 2005;4(11):705–11.</p><p>Андреев Н.А., Моисеев В.С. Антагонисты кальция в клинической медицине. М.: РЦ Фармединфо, 1995;161 с.</p><p>Захаров В.В., Дамулин И.В., Яхно Н.Н. Медикаментозная терапия деменций. Клин фармакол и тер 1994;3(4):69–75.</p><p>Захаров В.В., Яхно Н.Н. Нарушения памяти. М.: ГЭОТАР-Медиа, 2003;150.</p><p>Яхно Н.Н., Преображенская И.С. Лечение нейродегенеративных деменций. Консилиум 2004;6(12):935–43.</p><p>Kumor V., Calach M. Treatment of Alzheimer's disease with cholinergic drugs. Int J Clin Pharm Ther Toxicol 1991;29(1):23–37.</p><p>Дамулин И.В. Новая нейропротективная и терапевтическая стратегия при деменциях: антагонист NMDA-рецепторов Акатинол Мемантин. РМЖ 2001;9(25):1178–82.</p><p>Cowburn R., Hardy J., Roberts P. et al. Presynaptic and postsynaptic glutamatergic function in Alzheimer's disease. Neurosci Lett 1988;86:109–13.</p><p>Winblad B., Portis N. Severe dementia treatment. Int J Geriatr Psychiatr 1999;14:135–46.</p><p>Reisberg B., Windscheif U., Ferris S. et al. Memantine in moderately severe to severe Alzheimer’s disease: results of placebo-controlled</p><p>month trial. Neurobiol Aging 2000;21:S275.</p><p>Wilcock G., Stoeffler A., Sahin K. et al. Neuroradiological findings and the magnitude of cognitive benefit by memantine treatment. A subgroup analysis of two placebo-controlled clinical trials in vascular dementia. Eur Neuropsychopharm 2000;10(Suppl. 3):S360.</p><p>Tariot P.N., Farlow M.R., Grossberg G.T. et al. Memantine treatment in patients with moderate-to-severe Alzheimer’s disease already receiving donepizil: a randomized controlled trial. JAMA 2004;291(3):317–24.</p></div><br />
For citation:
Vakhnina N.V. Current therapy for cognitive impairments. Neurology, Neuropsychiatry, Psychosomatics. 2011;3(4):63-69. (In Russ.) https://doi.org/10.14412/2074-2711-2011-349
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