Current approaches to diagnosing and treating major neurocognitive disorder
https://doi.org/10.14412/2074-2711-2017-4-4-9
Abstract
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) replaces the term «dementia» with «major neurocognitive disorder» (MNCD), which can reduce the stigmatization of patients and focus the attention of specialists on the preserved abilities of patients rather than deficit symptoms. In the next 35 years, the number of patients with MNCD in the world is predicted to almost triple. The article considers the concept, epidemiology, and etiological pattern of this syndrome. It characterizes in detail Alzheimer's disease (AD) that is a cause of MNCD in 50–70% of cases. The current diagnostic criteria and clinical presentations of the disease are given. The presence of early and significant episodic memory disorders as both alone or concurrent with other cognitive and behavioral changes reflects the main clinical phenotype of AD. Magnetic resonance morphometry, amyloid positron emission tomography, and estimation of cerebrospinal fluid β-amyloid and tau protein levels find increasing applications in research and routine practice. Drug and non-drug treatments for MNCD are considered. The use of akatinol memantine to treat this disorder and the issues related to the comprehensive management of patients with severe cognitive impairment are analyzed.
About the Authors
A. A. Kulesh
Acad. E.A. Vagner Perm State Medical University, Ministry of Health of Russia
Russian Federation
26, Petropavlovskaya St., Perm, Perm Territory 614990
Russian Federation
26, Petropavlovskaya St., Perm, Perm Territory 614990
V. V. Shestakov
Acad. E.A. Vagner Perm State Medical University, Ministry of Health of Russia
Russian Federation
26, Petropavlovskaya St., Perm, Perm Territory 614990
Russian Federation
26, Petropavlovskaya St., Perm, Perm Territory 614990
References
1. Winblad B, Amouyel P, Andrieu S, et al. Defeating Alzheimer's disease and other dementias: a priority for European science and society. Lancet Neurol. 2016 Apr;15(5):455-532. doi: 10.1016/S1474-4422(16)00062-4.
2. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th ed. Washington, DC: American Psychiatric Association; 2013.
3. Prince M, Wimo A, Guerchet M, et al. World Alzheimer Report 2015: The global impact of dementia. An analysis of prevalence, incidence, costs and trends. London: Alzheimer’s Disease International; 2015.
4. Andrew E, Budson MD, Solomon PR. Memory Loss, Alzheimer's Disease, and Dementia. 2nd ed. Elsevier Inc.; 2016. 248 p.
5. Парфенов ВА, Захаров ВВ, Преображенская ИС. Когнитивные расстройства. Москва: Ремедиум; 2015. 187 с. [Parfenov VA, Zakharov VV, Preobrazhenskaya IS. Kognitivnye rasstroistva [Cognitive impairments]. Moscow: Remedium; 2015. 187 p.]
6. Todd S, Barr S, Roberts M, Passmore AP. Survival in dementia and predictors of mortality: a review. Int J Geriatr Psychiatry. 2013 Nov;28(11):1109-24. doi: 10.1002/gps.3946. Epub 2013 Mar 22.
7. Brodaty H, Seeher K, Gibson L. Dementia time to death: a systematic literature review on survival time and years of life lost in people with dementia. Int Psychogeriatr. 2012 Jul;24(7): 1034-45. doi: 10.1017/S1041610211002924. Epub 2012 Feb 13.
8. Corrada MM, Berlau DJ, Kawas CH. A population-based clinicopathological study in the oldest-old: the 90+ study. Curr Alzheimer Res. 2012 Jul;9(6):709-17.
9. Stern Y. Cognitive reserve in ageing and Alzheimer’s disease. Lancet Neurol. 2012 Nov; 11(11):1006-12. doi: 10.1016/S1474-4422(12)70191-6.
10. Barnes DE, Yaffe K. The projected effect of risk factor reduction on Alzheimer’s disease prevalence. Lancet Neurol. 2011 Sep;10(9): 819-28. doi: 10.1016/S1474-4422(11)70072-2. Epub 2011 Jul 19.
11. Qiu C, Xu W, Fratiglioni L. Vascular and psychosocial factors in Alzheimer’s disease: epidemiological evidence toward intervention. J Alzheimers Dis. 2010;20(3):689-97. doi: 10.3233/JAD-2010-091663.
12. Hugo J, Ganguli M. Dementia and cognitive impairment: epidemiology, diagnosis, and treatment. Clin Geriatr Med. 2014 Aug;30(3): 421-42. doi: 10.1016/j.cger.2014.04.001. Epub 2014 Jun 12.
13. McKhann GM, Knopman DS, Chertkow H, et al. The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement. 2011 May;7(3):263-9. doi: 10.1016/j.jalz.2011.03.005. Epub 2011 Apr 21.
14. Dubois B, Feldman HH, Jacova C, et al. Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria. Lancet Neurol. 2014 Jun;13(6):614-29. doi: 10.1016/S1474-4422(14)70090-0.
15. Парфенов ВА. Ранняя диагностика и лечение болезни Альцгеймера. Медицинский совет. 2015;(5):28-33. [Parfenov VA. Early diagnosis and treatment of Alzheimer's disease. Meditsinskii sovet. 2015;(5):28-33. (In Russ.)].
16. Scheltens P, Blennow K, Breteler MM, et al. Alzheimer's disease. Lancet. 2016 Jul 30;388(10043):505-17. doi: 10.1016/S0140-6736(15)01124-1. Epub 2016 Feb
17. Geda YE, Schneider LS, Gitlin LN, et al. and the Neuropsychiatric Syndromes Professional Interest Area of ISTAART. Neuropsychiatric symptoms in Alzheimer’s disease: past progress and anticipation of the future. Alzheimers Dement. 2013 Sep;9(5):602-8. doi: 10.1016/j.jalz.2012.12.001. Epub 2013 Apr 3.
18. Braskie MN, Thompson PM. A focus on structural brain imaging in the Alzheimer’s disease neuroimaging initiative. Biol Psychiatry. 2014 Apr 1;75(7):527-33. doi: 10.1016/j.biopsych.2013.11.020. Epub 2013 Nov 28.
19. Perani D, Della Rosa PA, Cerami C, et al. Validation of an optimized SPM procedure for FDG-PET in dementia diagnosis in a clinical setting. Neuroimage Clin. 2014 Oct 24;6:445-54. doi: 10.1016/j.nicl.2014.10.009. eCollection 2014.
20. Womack KB, Diaz-Arrastia R, Aizenstein HJ, et al. Temporoparietal hypometabolism in frontotemporal lobar degeneration and associated imaging diagnostic errors. Arch Neurol. 2011 Mar;68(3):329-37. doi: 10.1001/archneurol.2010.295. Epub 2010 Nov 8.
21. Nordberg A, Rinne JO, Kadir A, Langströ m B. The use of PET in Alzheimer disease. Nat Rev Neurol. 2010 Feb;6(2):78-87. doi: 10.1038/nrneurol.2009.217.
22. Marchant NL, Reed BR, DeCarli CS, et al. Cerebrovascular disease, beta-amyloid, and cognition in aging. Neurobiol Aging. 2012 May;33(5):1006.e25-36. doi: 10.1016/j.neurobiolaging.2011.10.001. Epub 2011 Nov 1.
23. Парфенов ВА, Науменко АА, Преображенская ИС. Лекарственные и нелекарственные методы лечения болезни Альцгеймера. Фарматека. 2015;(7):72-9. [Parfenov VA, Naumenko AA, Preobrazhenskaya IS. Medicinal and non-medicinal methods of treatment of Alzheimer's disease. Farmateka. 2015; (7):72-9. (In Russ.)].
24. Butterfield DA, Pocernich CB. The glutamatergic system and Alzheimer’s disease: therapeutic implications. CNS Drugs. 2003;17(9): 641-52.
25. McShane R, Areosa Sastre A, Minakaran N. Memantine for dementia. Cochrane Database Syst Rev. 2006 Apr 19;(2): CD003154.
26. Livingston G, Sommerlad A, Orgeta V, et al. Dementia prevention, intervention, and care. Lancet. 2017 Jul 19. pii: S0140-6736(17)31363-6. doi: 10.1016/S0140-6736(17)31363-6. Epub ahead of print.
27. Парфенов ВА. Лечение дегенеративной и сосудистой деменции: возможности применения мемантина. Эффективная фармакотерапия. 2013;(47):24-30. [Parfenov VA. Treatment of degenerative and vascular dementia: possible use of memantine. Effektivnaya farmakoterapiya. 2013;(47):24-30. (In Russ.)].
28. Thomas SJ, Grossberg GT. Memantine: a review of studies into its safety and efficacy in treating Alzheimer’s disease and other dementias. Clin Interv Aging. 2009;4:367-77. Epub 2009 Oct 12.
29. Willis SL, Tennstedt SL, Marsiske M, et al; ACTIVE Study Group. Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA. 2006 Dec 20; 296(23):2805-14.
30. Spector A, Orrell M, Hall L. Systematic review of neuropsychological outcomes in dementia from cognition-based psychological interventions. Dement Geriatr Cogn Disord. 2012;34(3-4):244-55. doi: 10.1159/000343931. Epub 2012 Nov 23.
31. Clare L, Linden DE, Woods RT, et al. Goal-oriented cognitive rehabilitation for people with early-stage Alzheimer disease: a singleblind randomized controlled trial of clinical efficacy. Am J Geriatr Psychiatry. 2010 Oct; 18(10):928-39. doi: 10.1097/JGP.0b013e3181d5792a.
32. Spector A, Thorgrimsen L, Woods B, Orrell M. Making a difference: An evidencebased group programme to offer Cognitive Stimulation therapy (CST) to people with dementia. London: Hawker Publications; 2006.
33. Brodaty H, Arasaratnam C. Meta-analysis of nonpharmacological interventions for neuropsychiatric symptoms of dementia. Am J Psychiatry. 2012 Sep;169(9):946-53. doi: 10.1176/appi.ajp.2012.11101529.
34. Corbett A, Stevens J, Aarsland D, et al. Systematic review of services providing information and/or advice to people with dementia and/or their caregivers. Int J Geriatr Psychiatry. 2012 Jun;27(6):628-36. doi: 10.1002/gps.2762. Epub 2011 Oct 28.
Review
For citations:
Kulesh A.A., Shestakov V.V. Current approaches to diagnosing and treating major neurocognitive disorder. Neurology, Neuropsychiatry, Psychosomatics. 2017;9(4):4-9. (In Russ.) https://doi.org/10.14412/2074-2711-2017-4-4-9
Views: 1419
Email this article 