The influence of nondrug methods on cognitive and emotional-affective disorders in patients with mild vascular cognitive impairment

Abstract

Emotional-affective disorders often accompany vascular cognitive impairment. Currently, there is insufficient data on the impact of non-drug treatment of cognitive impairment on the emotional sphere. The aim of the study was to evaluate the effect of non-drug methods (meal planning, exercise, cognitive training) on anxiety and depression in patients with mild cognitive impairment of vascular etiology. Material and methods. The study included 60 patients aged 45 to 88 years (mean age 63.9 ± 9.7, 26 males and 34 females) with mild cognitive impairment of vascular etiology. 30 patients (study group, 18 women, 12 men, mean age 63.7 ± 8.8 years, Montreal Cognitive Assessment (MoCA) score 22.5 ± 2.4) received a set of non-drug methods for 1 month, including cognitive training, detailed recommendations on physical activity and meal planning. Patients in the control group (n = 30, 16 women, 14 men, mean age — 64.2 ± 10.7 years, MoCA score — 21.7 ± 2.4 points) were once informed by the attending physician about the expediency of a physically and cognitively active lifestyle and the basic principles diets, however, systematic training with them was not carried out. Anxiety and depression were assessed at the stage of inclusion in the study, after 1 month, after 6 months, and one year after the start of observation using the Beck Depression Scale, the Spielberger–Khanin Anxiety Scale. Results. 1 month after the start of the study, along with a significant (p < 0.05) improvement in cognitive functions according MoCA, a significant decrease in the severity of anxiety was noted in the study group (p < 0.05). In patients with mild and moderate depression (n = 13), a significant (p < 0.05) regression in the severity of depression was recorded after a month of using non-drug methods. However, in the process of long-term follow-up (1 year), the differences with the initial visit for these indicators lost statistical significance. In the control group, a month after the start of the study, there were no significant differences in the MoCA test (p > 0.05), while the indicators of anxiety and depression worsened throughout the entire observation period. The study group significantly (p < 0.05) outperformed the control group in the MoCA test immediately after treatment and after 6 months. Differences of anxiety level were significant only immediately after treatment. Conclusion. A complex of non-drug methods is effective in the treatment of vascular MCI and reduces anxiety in patients. In patients with mild and moderate depression decrease of depression symptoms was observed also. However the effect of the monthly course was not stable.