Management of patients with mild cognitive impairment: the possibility of using nitric oxide

Abstract

Cognitive impairment (CI) is one of the leading causes of disability in the elderly, most often caused by neurodegenerative disease (NDD) and/or cerebrovascular disease (CVD). Mild CI (MCI) represents an intermediate state between normal cognitive functions (CF) and dementia and occurs in a significant proportion of the elderly. Patients with MCI have a higher risk of developing dementia than in the general population; therefore, prevention of the progression of MCI is an important area of modern neurology. Currently, no drugs have been found that can slow the progression of CI caused by CVD or NDD; drugs effective for dementia do not have a significant effect at the stage of MCI. In the prevention of dementia at the stage of MCI, an important role is noted for non-drug methods (regular physical activity, rational nutrition, mental activity, smoking cessation and alcohol abuse) and drug interventions (antihypertensive therapy, antithrombotic therapy, statins). In recent years, the use of nitric oxide in CVD and NDD has been discussed in order to attenuate the processes of oxidative stress, the release of cytokines, and the processes of apoptosis. In our country, there is a positive experience of inhaled use of nitric oxide with the help of an apparatus synthesized from the air for pulmonary, cardiovascular diseases and CVD. The effectiveness of inhaled nitric oxide using an apparatus synthesized from air is currently being studied in patients with MCI due to CVD and NDD. A clinical observation of a patient with MCI is presented, in which a month after the inhalation use of nitric oxide, an improvement in CF was noted according to neuropsychological examination.