Cerebrovascular diseases and cognitive impairment: therapy approaches

Abstract

The issue of cerebral vascular pathology is one of the most important social problems in the modern world, and Russia is no exception. Cerebrovascular diseases are distinguished by high prevalence, mortality and disability rates. They are of great importance from a health perspective of not only each individual, but total nation. Acute or chronic disorders of cerebral circulation naturally results from atherosclerosis of the major arteries of the head, hypertensive disease, and other cardiovascular diseases. These factors cause pathology of large and small cerebral vessels, which leads to chronic cerebral ischemia and (or) acute cerebrovascular accident with damage to various brain structures. Cognitive impairment is probably the most common presentation of cerebrovascular insufficiency. The severity of cognitive impairment can vary significantly depending on the stage of the condition and the severity of the underlying vascular disease - from mild cognitive impairment to dementia. Vascular cognitive impairment can be caused by several mechanisms. Small vessel ischemic disease is one of the pathological conditions that cause the development of cognitive impairment and dementia. Other presentations of cerebrovascular disorders can include multi-infarction, hypoperfusion, hemorrhagic, hereditary and mixed dementia. Current strategies for the management of patients with vascular cognitive impairment and dementia include symptomatic treatment, risk factor management, and non-pharmacological approaches aimed at preventing their progression.