Preview

Neurology, Neuropsychiatry, Psychosomatics

Advanced search

The possibilities of diagnosing and treating cognitive impairment at non-dementia stages

https://doi.org/10.14412/2074-2711-2020-5-78-83

Abstract

At the present stage of development of medicine and society, there is no doubt that early detection and treatment of nervous system diseases accompanied by impaired cognitive functions is one of the main tasks of clinical neurology. The prevalence of cognitive impairment (CI) is so high that today we can say that it exceeds the particular "epidemic" threshold, when the problem causes not only medical, but also a serious socioeconomic burden. Currently, studies of the problem of CI have shifted focus to the non-dementia stages of diseases. In recent years, it has become possible to make early nosological diagnosis of CI even before the development of dementia, which is associated with the development and introduction of in vivo laboratory and neuroimaging markers of Alzheimer's, neurodegenerative, and vascular processes. The paper discusses the existing classification and diagnostic criteria for non-dementia stages of CI. It proposes a new category, such as the initial signs of cognitive impairment, and presents diagnostic criteria. The author considers the importance of an integrated approach to diagnosing CI with the aim of early identification of the nosological entity of the syndrome. He presents a critical review of existing approaches to preventing and treating the non-dementia stages of CI.

About the Author

A. Yu. Emelin
S.M. Kirov Military Medical Academy, Ministry of Defense of Russia
Russian Federation

Andrey Yu. Emelin

6, Academician Lebedev St., Saint Petersburg 194044




References

1. Petersen R, Touchon J. Consensus on mild cognitive impairment. Research and practice in AD. EADS-ADCS Joint Meeting. 2005;10:24-32.

2. Zakharov VV. Diagnosis and treatment of moderate cognitive impairment. Russkii meditsinskii zhurnal. 2006;14(9):685-8 (In Russ.).

3. Yemelin AYu, Lobzin VYu. Umerennyye kognitivnyye narusheniya: Uchebnoye posobiye [Moderate Cognitive Impairment: A Study Guide]. St. Petersburg: VMedA; 2018. 87 p. (In Russ.).

4. Yakhno NN, Lokshina AB, Zakharov VV. Mild to moderate cognitive impairment in discirculatory encephalopathy. Klinicheskaya gerontologiya. 2005;11(9):38-9 (In Russ.).

5. Langa K, Levine D. The diagnosis and management of mild cognitive impairment: a clinical review. JAMA. 2014 Dec 17;312(23):2551-61. doi: 10.1001/jama.2014.13806

6. Roberts R, Knopman D. Classification and Epidemiology of MCI. Clin Geriatr Med. 2013 Nov;29(4):753-72. doi: 10.1016/j.cger.2013.07.003

7. Jack C, Albert M, Knopman D, McKhann G. Introduction to the recommendations from the National Institute on AgingAlzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 2011 May;7(3):257-62. doi: 10.1016/j.jalz.2011.03.004. Epub 2011 Apr 21.

8. Emelin AYu. Cognitive impairments in cerebrovascular disease: What is between health and dementia? Nevrologiya, neyropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2015;7(1):94-8. doi: 10.14412/2074-2711-2015-1-94-98 (In Russ.).

9. Levin OS, Golubeva LV. Heterogeneity of mild cognitive impairment: diagnostic and therapeutic aspects. Konsilium. 2006;8(2):106-10 (In Russ.).

10. Yemelin AYu, Lobzin VYu, Vorob'yev SV. Kognitivnyye narusheniya: rukovodstvo dlya vrachey [Cognitive Impairment: A Guide for Physicians]. Moscow; 2019. 416 p. (In Russ.).

11. Zakharov VV, Gromova DO. Modern approaches to the management of patients with moderate cognitive impairment. Zhurnal nevrologii i psikhiatrii im. S.S. Korsakova. 2017;(3):107-12 (In Russ.).

12. Cooper C, Li R, Lyketsos C, Livingston G. Treatment for mild cognitive impairment: systematic review. Br J Psychiatry. 2013 Sep;203(3):255-64. doi: 10.1192/bjp.bp.113.127811

13. Heyn P, Abreu B, Ottenbacher K. The effects of exercise training on elderly persons with cognitive impairment and dementia: a meta-analysis. Arch Phys Med Rehabil. 2004 Oct;85(10):1694- 704. doi: 10.1016/j.apmr.2004.03.019

14. Ngandu T, Lehtisalo J, Solomon A, et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet. 2015;385(9984):2255-63. doi: 10.1016/S0140-6736(15)60461-5

15. Scrameas N, Stern Y, Tang M, et al. Mediterranean diet and risk for Alzheimer's disease. Ann Neurol. 2006;59(6):877-9. doi: 10.1002/ana.20898

16. Petersen R, Lopez O, Armstrong M, et al. Practice guideline update summary: Mild cognitive impairment: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology. Neurology. 2018;90(3):126-35. doi: 10.1212/WNL.0000000000004826

17. Petersen R, Thomas R, Grundman M, et al. Vitamin E and donepezil for the treatment of mild cognitive impairment. N Engl J Med. 2005 Jun 9;352(23):2379-88. doi: 10.1056/NEJMoa050151

18. Feldman H, Ferris S, Winblad B, et al. Effect of rivastigmine on delay to diagnosis of Alzheimer's disease from mild cognitive impairment: the InDDEx study. Lancet Neurol. 2007 Jun;6(6):501-12. doi: 10.1016/S1474-4422(07)70109-6

19. Folch J, Busquets O, Ettcheto M. Memantine for the treatment of dementia: a review on its current and future applications. J Alzheimers Dis. 2018;62(3):1223-40. doi: 10.3233/JAD-170672

20. Wang W, Liu L, Chen C, et al. Protective effects of dopamine D2/D3 receptor agonist piribedil on learning and memory of rats exposed to global cerebral ischemia-reperfusion. Neurosci Lett. 2018;684:181-6. doi: 10.1016/j.neulet.2018.08.011

21. Pilipovich AA. Memory impairments and the role of pronoran in their correction. Effektivnaya farmakoterapiya. 2016;(9):8-17 (In Russ.).

22. Bille J, Bukiwsky J, de Ferron A, et al. Decline cerebral et therapeutique: une etude clinique multicenrique de Trivastal 50 retard en neuro-geriatrie. Psych Med. 1986;18:609-26.

23. Nagaraia D, Jayashree S. Randomised study of the dopamine receptor agonist piribedil in the treatment of mild cognitive impairment. Am J Psychiatry. 2001 Sep;158(9):1517-9. doi: 10.1176/appi.ajp.158.9.1517

24. Zakharov VV. All-Russian research program for epidemiology and therapy of cognitive disorders in old age («Prometheus»). Nevrologicheskiy zhurnal. 2006;11(2):27-32 (In Russ.).

25. Yakhno NN, Zakharov VV, Strachunskaya YeYa, et al. Treatment of non-dementia cognitive impairments in patients with arterial hypertension and cerebral atherosclerosis (Based on the results of the Russian multicenter study FUETE). Nevrologicheskiy zhurnal. 2012;17(4):49-55 (In Russ.).


Review

Views: 404


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)