Severity and treatment of cognitive impairment
https://doi.org/10.14412/2074-2711-2021-3-119-124
Abstract
With an increase in life expectancy in the population, the proportion of people with cognitive impairment (CI) increases. Modern neurology focuses on the milder forms of CI: moderate, mild, and subjective CI, which are more promising in terms of successful treatment and slowing down their progression. Age is the leading risk factor for CI, the prevalence of which in the general population of people aged over 65 years reaches 10–15%. The primary role in CI development is played by Alzheimer's disease, cerebrovascular diseases, mixed vascular-neurodegenerative process, and other types of neurodegenerative diseases, and all of them share some pathophysiological mechanisms. Correction of vascular risk factors plays a leading role in the treatment of pre-dementia stages of CI. The possibilities of using nimodipine in the therapy of CI are analyzed.
Keywords
dementia,
cognitive impairment without dementia,
mild cognitive impairment,
near-moderate cognitive decline,
subjective cognitive impairment,
prevention,
treatment,
nimodipine
Supporting agencies: This article has been supported by ESKO PHARMA
About the Authors
Yu. A. Starchina
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
Russian Federation
Yulia Aleksandrovna Starchina
Department of Nervous System Diseases and Neurosurgery, N.V. Sklifosovsky Institute of Clinical Medicine
11, Rossolimo St., Build. 1, Moscow 119021
V. V. Zakharov
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation
Russian Federation
Department of Nervous System Diseases and Neurosurgery, N.V. Sklifosovsky Institute of Clinical Medicine
11, Rossolimo St., Build. 1, Moscow 119021
References
1. Arvanitakis Z, Shah RC, Bennett DA. Diagnosis and management of dementia: review. JAMA. 2019 Oct 22;322(16):1589-99. doi: 10.1001/jama.2019.4782
2. Di Carlo A, Lamassa M, Baldereschi M, et al. CIND and MCI in the Italian elderly: frequency, vascular risk factors, progression to dementia. Neurology. 2007 May 29;68(22):1909- 16. doi: 10.1212/01.wnl.0000263132.99055.0d
3. Ganguli M, Chang CC, Snitz BE, et al. Prevalence of mild cognitive impairment by multiple classifications: The Monongahela-Youghiogheny Healthy Aging Team (MYHAT) project. Am J Geriatr Psychiatry. 2010 Aug;18(8):674-83. doi: 10.1097/JGP.0b013e3181cdee4f
4. Larrieu S, Letenneur L, Orgogozo JM, et al. Incidence and outcome of mild cognitive impairment in a population-based prospective cohort. Neurology. 2002 Nov 26;59(10):1594-9. doi: 10.1212/01.wnl.0000034176.07159.f8
5. Roberts RO, Geda YE, Knopman DS, et al. The Mayo Clinic Study of Aging: design and sampling, participation, baseline measures and sample characteristics. Neuroepidemiology. 2008;30(1):58- 69. doi: 10.1159/000115751. Epub 2008 Feb 7.
6. Sonnen JA, Larson EB, Crane PK, et al. Pathological correlates of dementia in a longitudinal, population-based sample of aging. Ann Neurol. 2007 Oct;62(4):406-13. doi: 10.1002/ana.21208
7. White L, Petrovitch H, Hardman J, et al. Cerebrovascular pathology and dementia in autopsied Honolulu-Asia Aging Study participants. Ann N Y Acad Sci. 2002 Nov;977:9-23. doi: 10.1111/j.1749-6632.2002.tb04794.x
8. Zakharov VV. All-Russian Research Program for Epidemiology and Therapy of Cognitive Disorders in Old Age («Prometheus»). Nevrologicheskiy zhurnal. 2006;(11):27-32 (In Russ.).
9. American Psychiatric Association. Neurocognitive disorders. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th ed. Washington, DC: American Psychiatric Association; 2013. Ch. 20.
10. World Health Organization: Dementia: A Public Health Priority; 2012.
11. Raz L, Knoefel J, Bhaskar K. The neuropathology and cerebrovascular mechanisms of dementia. J Cereb Blood Flow Metab. 2016 Jan;36(1):172-86. doi: 10.1038/jcbfm.2015.164
12. Petersen RC. Mild cognitive impairment as a diagnostic entity. J Intern Med. 2004 Sep;256(3):183-94. doi: 10.1111/j.1365-2796.2004.01388.x
13. Petersen RC, Knopman DS, Boeve BF, et al. Mild cognitive impairment: 10 years later. Arch Neurol. 2009 Dec;66(12):1447-55. doi: 10.1001/archneurol.2009.266
14. Parfenov VA, Zakharov VV, Preobrazhenskaya IS. Kognitivnyye rasstroystva [Cognitive Disorders]. Moscow; 2014. 192 p. (In Russ.).
15. Zakharov VV. Evolution of cognitive deficit: mild and moderate cognitive impairments. Nevrologiya, neyropsikhiatriya i psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2012;4(2):16-21. doi: 10.14412/2074-2711-2012-376 (In Russ.).
16. Petersen RC. Mild Cognitive Impairment. Continuum (Minneap Minn). 2016 Apr;22(2 Dementia):404-18. doi: 10.1212/CON.0000000000000313
17. Yakhno NN. Cognitive disorders in a neurological clinic. Nevrologicheskiy zhurnal. 2006;11(Suppl. 1):4-12 (In Russ.).
18. Bassett SS, Folstein MF. Memory complaint, memory performance, and psychiatric diagnosis: a community study. J Geriatr Psychiatry Neurol. Apr-Jun 1993;6(2):105-11. doi: 10.1177/089198879300600207
19. Matthews FE, Arthur A, Barnes LE, et al. A two-decade comparison of prevalence of dementia in individuals aged 65 years and older from three geographical areas of England: results of the Cognitive Function and Ageing Study I and II. Lancet. 2013 Oct 26;382(9902):1405-12. doi: 10.1016/S0140-6736(13)61570-6. Epub 2013 Jul 17.
20. Jessen F, Amariglio RE, van Boxtel M, et al. Subjective Cognitive Decline Initiative (SCD-I) Working Group. A conceptual framework for research on subjective cognitive decline in preclinical Alzheimer's disease. Alzheimers Dement. 2014 Nov;10(6):844-52. doi: 10.1016/j.jalz.2014.01.001. Epub 2014 May 3.
21. Striepens N, Scheef L, Wind A, et al. Volume loss of the medial temporal lobe structures in subjective memory impairment. Dement Geriatr Cogn Disord. 2010;29(1):75-81. doi: 10.1159/000264630. Epub 2010 Jan 28.
22. Mosconi L, De Santi S, Brys M, et al. Hypometabolism and altered cerebrospinal fluid markers in normal apolipoprotein E E4 carriers with subjective memory complaints. Biol Psychiatry. 2008 Mar 15;63(6):609-18. doi: 10.1016/j.biopsych.2007.05.030. Epub 2007 Aug 27.
23. Perrotin A, Mormino EC, Madison CM, et al. Subjective cognition and amyloid deposition imaging: A Pittsburgh Compound B positron emission tomography study in normal elderly individuals. Arch Neurol. 2012 Feb;69(2):223-9. doi: 10.1001/archneurol.2011.666
24. Amariglio RE, Becker JA, Carmasin J, et al. Subjective cognitive complaints and amyloid burden in cognitively normal older individuals. Neuropsychologia. 2012 Oct;50(12):2880-6. doi: 10.1016/j.neuropsychologia.2012.08.011. Epub 2012 Aug 23.
25. Hessen E, Eckerström M, Nordlund A, et al. Subjective Cognitive Impairment Is a Predominantly Benign Condition in Memory Clinic Patients Followed for 6 Years: The Gothenburg-Oslo MCI Study. Dement Geriatr Cogn Dis Extra. 2017 Feb 2;7(1):1-14. doi: 10.1159/000454676. eCollection Jan-Apr 2017.
26. Eckerström M, Berg AI, Nordlund A, et al. High Prevalence of Stress and Low Prevalence of Alzheimer Disease CSF Biomarkers in a Clinical Sample with Subjective Cognitive Impairment. Dement Geriatr Cogn Disord. 2016;42(1-2):93- 105. doi: 10.1159/000448326. Epub 2016 Sep 9.
27. Parfenov VA, Starchina YuA, Yakhno NN. Eprosartan (Teveten) in the prevention of recurrent stroke and cognitive impairment. Nevrologicheskiy zhurnal. 2007;(1):46-51 (In Russ.).
28. Parfenov VA, Khasanova DR. Ishemicheskiy insul't [Ischemic stroke]. Moscow: MIA; 2012. 288 p. (In Russ.).
29. Livingston G, Sommerlad A, Orgeta V, et al. Dementia prevention, intervention, and care. Lancet. 2017 Dec 16;390(10113):2673-734. doi: 10.1016/S0140-6736(17)31363-6. Epub 2017 Jul 20.
30. Van de Glind EMM, van Enst WA, van Munster BC, et al. Pharmacological Treatment of Dementia: A Scoping Review of Systematic Reviews. Dement Geriatr Cogn Disord. 2013;36(3-4):211-28. doi: 10.1159/000353892. Epub 2013 Aug 12.
31. Tisher A, Salardini A. A Comprehensive Update on Treatment of Dementia. Semin Neurol. 2019 Apr;39(2):167-78. doi: 10.1055/s0039-1683408. Epub 2019 Mar 29.
32. Amieva H, Ouvrard C, Giulioli C, et al. Self-Reported Hearing Loss, Hearing Aids, and Cognitive Decline in Elderly Adults: A 25-Year Study. J Am Geriatr Soc. 2015 Oct;63(10):2099-104. doi: 10.1111/jgs.13649
33. Uchida Y, Nishita Y, Tange C, Sugiura S. The Longitudinal Impact of Hearing Impairment on Cognition Differs According to Cognitive Domain. Front Aging Neurosci. 2016 Aug 22;8:201. doi: 10.3389/fnagi.2016.00201. eCollection 2016.
34. Fritze T, Teipel S, Ovari A, et al. Hearing Impairment Affects Dementia Incidence. An Analysis Based on Longitudinal Health Claims Data in Germany. PLoS One. 2016 Jul 8;11(7):e0156876. doi: 10.1371/journal.pone.0156876. eCollection 2016.
35. Jefferis JM, Mosimann UP, Clarke MP. Cataract and Cognitive Impairment: A Review of the Literature. Br J Ophthalmol. 2011 Jan;95(1):17-23. doi: 10.1136/bjo.2009.165902. Epub 2010 Aug 31.
36. Roberts RO, Cha RH, Mielke MM, et al. Risk and protective factors for cognitive impairment in persons aged 85 years and older. Neurology. 2015 May 5;84(18):1854-61. doi: 10.1212/WNL.0000000000001537. Epub 2015 Apr 8.
37. Andel R, Crowe M, Pedersen NL, et al. Physical exercise at midlife and risk of dementia three decades later: a population-based study of Swedish twins. J Gerontol A Biol Sci Med Sci. 2008 Jan;63(1):62-6. doi: 10.1093/gerona/63.1.62
38. Ahlskog JE, Geda YE, Graff-Radford NR, et al. Physical Exercise as a Preventive or Disease-Modifying Treatment of Dementia and Brain Aging. Mayo Clin Proc. 2011 Sep;86(9):876-84. doi: 10.4065/mcp.2011.0252
39. Morris MC, Tangney CC, Wang Y, et al. MIND diet associated with reduced incidence of Alzheimer's disease. Alzheimers Dement. 2015 Sep;11(9):1007-14. doi: 10.1016/j.jalz.2014.11.009. Epub 2015 Feb 11.
40. Yaffe K, Laffan AM, Harrison SL, et al. Sleep-Disordered Breathing, Hypoxia, and Risk of Mild Cognitive Impairment and Dementia in Older Women. JAMA. 2011 Aug 10;306(6):613- 9. doi: 10.1001/jama.2011.1115
41. Chang WP, Liu ME, Chang WC. Sleep apnea and the risk of dementia: a population-based 5-year follow-up study in Taiwan. PLoS One. 2013 Oct 24;8(10):e78655. doi: 10.1371/journal.pone.0078655. eCollection 2013.
42. Cooper C, Sommerlad A, Lyketsos CG, Livingston G. Modiёable predictors of dementia in mild cognitive impairment: a systematic review and meta-analysis. Am J Psychiatry. 2015 Apr;172(4):323-34. doi: 10.1176/appi.ajp.2014.14070878. Epub 2015 Feb 20.
43. Saczynski JS, Beiser A, Seshadri S, et al. Depressive symptoms and risk of dementia: the Framingham Heart Study. Neurology. 2010 Jul 6;75(1):35-41. doi: 10.1212/WNL.0b013e3181e62138
44. Dotson VM, Beydoun MA, Zonderman AB. Recurrent depressive symptoms and the incidence of dementia and mild cognitive impairment. Neurology. 2010 Jul 6;75(1):27-34. doi: 10.1212/WNL.0b013e3181e62124
45. 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 Jun 6;385(9984):2255-63. doi: 10.1016/S0140-6736(15)60461-5. Epub 2015 Mar 12.
46. McShane R, Areosa Sastre A, Minakaran N. Memantine fordementia. Cochrane Database Syst Rev. 2006 Apr 19;(2):CD003154. doi: 10.1002/14651858.CD003154.pub5
47. Emre M, Tsolaki M, Bonuccelli U, et al; 11018 Study Investigators. Memantine for patients with Parkinson's disease dementia ordementia with Lewy bodies: a randomised, double-blind, placebo-controlled trial. Lancet Neurol. 2010 Oct;9(10):969-77. doi: 10.1016/S1474-4422(10)70194-0. Epub 2010 Aug 20.
48. Howard R, McShane R, Lindesay J, et al. Nursing home placementin the donepezil and memantine in moderate to severe Alzheimer's disease (DOMINO-AD) trial: secondary and post-hoc analyses. Lancet Neurol. 2010 Oct;9(10):969-77. doi: 10.1016/S1474-4422(10)70194-0. Epub 2010 Aug 20.
49. Diniz BS, Pinto JA, Gonzaga MCG. To treat or not to treat? A meta-analysis of the use of cholinesterase inhibitors in mild cognitive impairment for delaying progression to Alzheimer's disease. Eur Arch Psychiatry Clin Neurosci. 2009 Jun;259(4):248-56. doi: 10.1007/s00406-008-0864-1. Epub 2009 Feb 17.
50. Russ TC. Cholinesterase Inhibitors Should Not Be Prescribed for Mild Cognitive Impairment. Evid Based Med. 2014 Jun;19(3):101. doi: 10.1136/eb-2013-101687. Epub 2014 Jan 30.
51. Winblad B, Gauthier S, Scinto L, et al. Safety and efficacy of galantamine in subjects with mild cognitive impairment. Neurology. 2008 May 27;70(22):2024-35. doi: 10.1212/01.wnl.0000303815.69777.26. Epub 2008 Mar 5.
52. Petersen RC, Thomas RG, 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. Epub 2005 Apr 13.
53. Tomassoni D, Lanari A, Silvestrelli G, et al. Nimodipine and Its Use in Cerebrovascular Disease: Evidence from Recent Preclinical and Controlled Clinical Studies. Clin Exper Hypertens. 2008 Nov;30(8):744-66. doi: 10.1080/10641960802580232
54. Lopez-Arrieta J, Birks J. Nimodipine for primary degenerative, mixed and vascular dementia. Cochrane Database Syst Rev. 2002;(3):CD000147. doi: 10.1002/14651858.CD000147
55. Knopman DS. Treatment of mild cognitive impairment and prospects for prevention of Alzheimer's disease. In: Petersen RC, ed. Mild Cognitive Impairment: Aging to Alzheimer's Disease. Oxford: Oxford University Press; 2003. P. 243-58.
56. Lopez-Arrieta J. Nimodipine. In: Qizilbash N et al, eds. Evidence-Based Dementia Practice. Oxford: Blackwell Science; 2002. P. 537-40.
57. Ghanbari-Maman A, Ghasemian-Roudsari F, Aliakbari S, et al. Calcium Channel Blockade Ameliorates Endoplasmic Reticulum Stress in the Hippocampus Induced by Amyloidopathy in the Entorhinal Cortex. Iran J Pharm Res. Summer 2019;18(3):1466-76. doi: 10.22037/ijpr.2019.111532.13216
58. Wang P, Wang Y, Feng T, et al. Rationale and design of a double-blind,placebo-controlled, randomized trial to evaluate the safety and efficacy of nimodipine in preventing cognitive impairment in ischemic cerebrovascular events (NICE). BMC Neurol. 2012 Sep 5;12:88. doi: 10.1186/1471-2377-12-88
59. Ferszt R, Kanowski S. Nimodipine in the treatment of dementia. Drugs Today. 1998 Sep;34(9):767-76. doi: 10.1358/dot.1998.34.9.485275
60. Avery RB, Johnson D. Multiple channel types contribute to the low-voltage-activated calcium current in hippocampal CA3 pyramidal neurons. J Neurosci. 1996 Sep 15;16(18):5567-82. doi: 10.1523/JNEUROSCI.16-18-05567.1996
61. Campbell LW, Hao SY, Thibault O, et al. Aging changes in voltage-gated calcium currents in hippocampal CA1 neurons. J Neurosci. 1996 Oct 1;16(19):6286-95. doi: 10.1523/JNEUROSCI.16-19-06286.1996
Review
For citations:
Starchina YA, Zakharov VV. Severity and treatment of cognitive impairment. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2021;13(3):119-124. (In Russ.) https://doi.org/10.14412/2074-2711-2021-3-119-124
Views:
675
Email this article 