Issues of diagnosis and treatment of mild cognitive impairment

Abstract

Cognitive impairment refers to frequent disorders in the elderly and senile, and their prevalence increases with age significantly. Non-dementia cognitive disorders mean a spectrum of changes in the cognitive sphere that precede the development of dementia over the course of many months and even years. Mild forms of cognitive impairment (MCI) are the most studied type of pre-dementia conditions, which in most cases represent a prodromal stage of disorders progressing over time to a dementia syndrome. Early identification of individuals with MCI is important because timely diagnosis of these disorders is expanding the potential impact of the secondary prevention and therapeutic intervention, which can delay or even prevent the onset of professional and social maladaptation due to development of dementia. The article considers the historical issues of studying these disorders, presents the modern principles of their classification and diagnostic criteria. A clinical observation of a patient with a polyfunctional non-amnestic type MCI syndrome is provided. The features of cognitive disorders typical for chronic cerebrovascular insufficiency, such as mental retardation, impaired activity arrangement, difficulties with generalisation in relative preservation of memory and orientation in combination with emotional and affective disorders are described. The authors discuss issues of treatment of MCI syndrome, which should be comprehensive and include the correction of all vascular risk factors, non-drug (regular physical activity, cognitive training) and pharmacological treatments aimed at improving cognitive performance. The article describes the possibilities of modern neuroprotective and symptomatic therapy of cognitive impairment, showing the role of choline alfoscerate in the treatment of MCI.