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New possibilities for the treatment of mild cognitive impairment and prevention of dementia in patients with cerebrovascular disease. Results of the PRIORITET Observation Program

https://doi.org/10.14412/2074-2711-2023-1-65-70

Abstract

A common tool for detecting mild cognitive impairment (MCI) is the Montreal Cognitive Assessment (MoCA). An extension of the standard MoCA testing – MoCA-Memory Index Score (MoCA-MIS; Memory Index, MI) – allows a deeper study of the mechanisms of MCI formation. We consider the drug Prospecta as an effective measure to prevent the progression of MCI.
Objective: to study the efficacy and safety of Prospecta in the treatment of MCI in patients with cerebrovascular disease (CVD) in real clinical practice.
Material and methods. The observational program PRIORITET included 192 patients of both sexes aged 40 to 74 years inclusive (mean age 63.6±8.8 years) with MCI and CVD, they were prescribed Prospecta, two tablets twice a day during 24 weeks. The presence of MCI was confirmed by testing on the MoCA scale; MI was assessed additionally`. At the end of treatment, the condition of patients was assessed using the Overall Clinical Impression Scale and the safety of the therapy.
Results. The change in the mean score on the MoCA scale after 24 weeks of therapy with Prospecta was 5.3 (p<0.0001). The proportion of patients who responded positively to treatment with Prospecta and after 24 weeks of treatment restored their cognitive functions to normal (MoCA >26 points), reached 48.9%. Additionally, patients were divided into groups depending on the results of testing on the MoCA scale and MI. During therapy with Prospecta, the number of patients in the MIS <7 and MoCA <20 group decreased by 19 times, in the MIS <7 or MoCA <20 group – by 4.8 times. There were 16 adverse events, 75% of which were mild. In 62.5% of adverse events, there was no connection with taking Prospecta.
Conclusion. Prospecta is an effective and safe treatment for patients with MCI and CVD.

About the Authors

E. Y. Solovieva
Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation

117997, Moscow, Ostrovitianov St., 1


Competing Interests:

The conflict of interest has not affected the results of the investigation



P. R. Kamchatnov
Pirogov Russian National Research Medical University, Ministry of Health of Russia
Russian Federation

Pavel Rudolfovich Kamchatnov

117997, Moscow, Ostrovitianov St., 1


Competing Interests:

The conflict of interest has not affected the results of the investigation



L. B. Novikova
Bashkir State Medical University, Ministry of Health of Russia
Russian Federation

450008, Ufa, Lenina St., 3


Competing Interests:

The conflict of interest has not affected the results of the investigation



O. A. Kicherova
Tyumen State Medical University, Ministry of Health of Russia
Russian Federation

625023, Tyumen, Odesskaya St., 54


Competing Interests:

The conflict of interest has not affected the results of the investigation



N. M. Khasanova
Northern State Medical University, Ministry of Health of Russia
Russian Federation

163069, Arkhangelsk, Troitsky Prosp., 51


Competing Interests:

The conflict of interest has not affected the results of the investigation



References

1. Albert MS, DeKosky ST, Dickson D, et al. The diagnosis of mild cognitive impairment due to Alzheimer's disease: recommendations from the National Institute on AgingAlzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement. 2011;7:270-9. doi:10.1016/j.jalz.2011.03.008

2. Gauthier S, Reisberg B, Zaudig M, et al. Mild cognitive impairment. Lancet. 2006;367:1262-70. doi:10.1016/S0140-6736(06)68542-5

3. Clement F, Belleville S, Mellah S. Functional neuroanatomy of the encoding and retrieval processes of verbal episodic memory in MCI. Cortex. 2010;46:1005-15. doi:10.1016/j.cortex.2009.07.003

4. Dannhauser TM, Shergill SS, Stevens T, et al. An fMRI study of verbal episodic memory encoding in amnestic mild cognitive impairment. Cortex. 2008;44:869-80. doi:10.1016/j.cortex.2007.04.005

5. Salmon DP, Bondi MW. Neuropsychological assessment of dementia. Annu Rev Psychol. 2009;60:257-82. doi:10.1146/annurev.psych.57.102904.190024

6. Nasreddine ZS, Phillips NA, Bedirian V, et al. The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53:695-9. doi:10.1111/j.1532-5415.2005.53221.x

7. Ritter A, Hawley N, Banks SJ, Miller JB. The Association between Montreal Cognitive Assessment Memory Scores and Hippocampal Volume in a Neurodegenerative Disease Sample. J Alzheimers Dis. 2017;58(3):695-9. doi:10.3233/JAD-161241

8. Julayanont P, Brousseau M, Chertkow H, et al. Montreal Cognitive Assessment Memory Index Score (MoCA-MIS) as a predictor of conversion from mild cognitive impairment to Alzheimer's disease. J Am Geriatr Soc. 2014;62:679-84. doi:10.1111/jgs.12742

9. Vorobyeva OV, Nikulina KV, Fateeva VV. Correlation of oxidative stress and mild cognitive impairment in patients with cerebral atherosclerosis: results of a prospective cohort study. Effektivnaya farmakoterapiya. 2022;18(23):12-8. doi:10.33978/2307-3586-2022-18-23-12-18 (In Russ.).

10. Nikulina KV, Vorobieva OV, Fateeva VV. Effect of statins on oxidative stress and cognitive function in patients with cerebral atherosclerosis: results of a prospective cohort study. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2022;14(4):25-32. doi:10.14412/2074-2711-2022-4-25-32 (In Russ.).

11. Matthews FE, Stephan BCM, McKeith IG, et al. Two-year progression from mild cognitive impairment to dementia: To what extent do different definitions agree? J Am Geriatr Soc. 2008;56:1424-33. doi:10.1111/j.1532-5415.2008.01820.x

12. Maioli F, Coveri M, Pagni P, et al. Conversion of mild cognitive impairment to dementia in elderly subjects: A preliminary study in a memory and cognitive disorder unit. Arch Gerontol Geriatr. 2007;44(1):233-41. doi:10.1016/j.archger.2007.01.032

13. Instructions for the medical use of Prospect. Available from: https://grls.rosminzdrav.ru/Grls_View_v2.aspx?routingGuid=0c47ac45-d055-4879-b8f3-bf6d2400318f (accessed 13.12.2022) (In Russ.)

14. Voznyuk IA, Zavadenko NN, Kamchatnov PR, et al. Results of the round table: modern approaches to drug therapy of cognitive impairment in cerebrovascular pathology. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2021;121(8):147-52. doi:10.17116/jnevro2021121081147 (In Russ.).

15. Belova AN, Bogdanov EI, Voznyuk IA, et al. Therapy of moderate cognitive impairment in the early recovery period of ischemic stroke. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2021;121(5):33-9. doi:10.17116/jnevro202112105133 (In Russ.).

16. Shvartsman GI, Skoromets AA, Zhivolupov SA, et al. Therapy of moderate cognitive impairment and asthenia in patients with cerebrovascular pathology: results of a prospective observational study. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2022;122(8):88-94. doi:10.17116/jnevro202212208182 (In Russ.)

17. Framework for FDA’s Real-World Evidence Program. December 2018. Available from: https://www.fda.gov/media/120060/download (accessed 12.12.2022).

18. Yakhno NN. Cognitive disorders in a neurological clinic. Nevrologicheskiy zhurnal. 2006;11(Suppl. 1):4-12 (In Russ.)

19. Lokshina AB, Zakharov VV, Grishina DA, et al. Heterogeneity of the mild cognitive impairment syndrome (specialized outpatient service data analysis). Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2021;13(3):34-41. doi:10.14412/2074-2711-2021-3-34-41 (In Russ.).

20. Parfenov VA. Vascular cognitive impairment and chronic cerebral ischemia (dyscirculatory encephalopathy). Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2019;11(Suppl. 3):61-7. doi:10.14412/2074-2711-2019-3S-61-67 (In Russ.).

21. De Bruijn RF, Bos MJ, Portegies ML, et al. The potential for prevention of dementia across two decades: the prospective, population-based Rotterdam Study. BMC Med. 2015 Jul 21;13:132. doi:10.1186/s12916-015-0377-5

22. Barnes JN. Exercise, cognitive function, and aging. Adv Physiol Educ. 2015 Jun;39(2):55-62. doi:10.1152/advan.00101.2014


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For citations:


Solovieva EY, Kamchatnov PR, Novikova LB, Kicherova OA, Khasanova NM. New possibilities for the treatment of mild cognitive impairment and prevention of dementia in patients with cerebrovascular disease. Results of the PRIORITET Observation Program. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2023;15(1):65-70. (In Russ.) https://doi.org/10.14412/2074-2711-2023-1-65-70

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