Treatment of non-demented vascular cognitive disorders

Abstract

Currently, cognitive impairment is a determining factor in the decline in adaptation in the elderly. Damage to the cerebral vessels is one of the most common causes of the development of cognitive deficits. Patients with severe cognitive impairments are not easily treatable, require outside help, and have significant limitations in daily activities. In most cases, this stage is preceded by a period of mild cognitive impairment. As a rule, mild cognitive impairments often remain undiagnosed, since they do not cause restrictions in daily activities for a long time and are detected only thanks to highly specific neuropsychological tests. But it is precisely the timely diagnosis and treatment of cognitive impairment without dementia, that make it possible to achieve longterm remission of the disease, to delay the onset of pronounced cognitive deficit. Among the correction methods, non-drug methods and pharmacological therapy are distinguished. Of no small importance is the impact on vascular risk factors such as arterial hypertension, diabetes mellitus, hyperlipidemia, smoking, alcohol abuse, etc. Nutrition planning, dosed exercise and cognitive training are the most common non-pharmacological strategies for correcting cognitive impairment. Pharmacological treatment includes anticholinesterase and neurometabolic drugs, as well as drugs aimed at correcting risk factors. A growing number of researchers agree that complex therapy, including lifestyle modification and the use of pharmacotherapy, is preferable. The article discusses the most commonly used methods of treating non-demented cognitive impairments, presents the results of large randomized clinical trials devoted to this problem, presents our own experience of both exclusively non-drug effects on patients and the use of complex treatment using a neurometabolic drug.