Mild cognitive impairment in clinical practice


DOI: https://dx.doi.org/10.18565/therapy.2021.5.141-148

Bogolepova A.N.

1) N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, Moscow; 2) Federal Center of Brain Research and Neurotechnologies of FMBA, Moscow
Abstract. High prevalence of cognitive impairment, especially among the elderly, leads to decreased quality of life for patients, impaired daily activity, increased risk of dementia and mortality. Currently, much attention is paid to mild cognitive impairment (MCI). The article discusses the diagnostic criteria and possible clinical variants of this syndrome. Given the high frequency of progression of MCI to dementia, it is necessary to identify risk groups and carry out therapeutic measures for prevention. Correction of potentially modifiable risk factors is considered as a promising area of therapy. Adequate physical and mental activity, adherence to a proper diet, normalization of sleep, visual acuity and hearing are necessary. Prevention of stroke and control of vascular risk factors can reduce the risk of MCI progression to dementia.
Keywords: risk factors of MI, course of MI, clinical variants of MCI, diagnostic criteria of MCI, mild cognitive impairment (MCI), akatinol, memantine
Read entire article

Literature


  1. UN. World Population Ageing 2015. United Nations; San Francisco, CA, USA: 2015. Available at: https://www.un.org/development/desa/pd/sites/www.un.org.development.desa.pd/files/files/documents/2020/May/un_2015_worldpopulationageing_report.pdf (date of access – 04.05.2021).

  2. Crimmins E.M., Kim J.K., Langa K.M. et al. Assessment of cognition using surveys and neuropsychological assessment: The Health and Retirement Study and the Aging, Demographics, and Memory Study. J Gerontol B Psychol Sci Soc Sci. 2011; 66 Suppl 1(Suppl 1): i162–71. doi: 10.1093/geronb/gbr048.

  3. Неврология. Национальное руководство. Под ред. Е.И. Гусева, А.Н. Коновалова, В.И. Скворцовой. 2-е изд., перераб. и доп. М.: ГЭОТАР-Медиа. 2018; 880 с. [Neurology. National guides. Ed.by Gusev E.I., Konovalov A.N., Skvortsova V.I. 2nd edition, revised and enlarged. M: GEOTAR-Media. 2018; 880 pp. (In Russ.)]. ISBN: ISBN 978-5-9704-4143-5.

  4. Pais R., Ruano L., Moreira C. et al. Prevalence and incidence of cognitive impairment in an elder Portuguese population (65–85 years old). BMC Geriatr. 2020; 20(1): 470. doi: 10.1186/s12877-020-01863-7.

  5. Pais R., Ruano L., Carvalho O.P., Barros H. Global cognitive impairment prevalence and incidence in community dwelling older adults-a systematic review. Geriatrics (Basel). 2020; 5(4): 84. doi: 10.3390/geriatrics5040084.

  6. Jongsiriyanyong S., Limpawattana P. Mild cognitive impairment in clinical practice: a review article. Am J Alzheimers Dis Other Demen. 2018; 33(8): 500–07. doi: 10.1177/1533317518791401.

  7. Petersen R.C., Smith G.E., Waring S.C. et al. Mild cognitive impairment: clinical characterization and outcome. Arch Neurol. 1999; 56(3):303–08.

  8. Roberts R., Knopman D.S. Classification and epidemiology of MCI. Clin. Geriatr. Med. 2013; 29: 753–72. doi: 10.1016/j.cger.2013.07.003.

  9. Espino D.V., Lichtenstein M.J., Palmer R.F., Hazuda H.P. Ethnic differences in Mini-Mental State Examination (MMSE) scores: where you live makes a difference. J Am Geriatr Soc. 2001; 49(5): 538–48. doi: 10.1046/j.1532-5415.2001.49111.x.

  10. Langa K.M., Levine D.A. The diagnosis and management of mild cognitive impairment: a clinical review. JAMA. 2014; 312(23): 2551–61. doi: 10.1001/jama.2014.13806.

  11. Ward A., Tardiff S., Dye C. et al. Rate of conversion from prodromal Alzheimer’s disease to Alzheimer’s dementia: a systematic review of the literature. Dement Geriatr Cogn Dis Extra. 2013; 3(1): 320–32. doi: 10.1159/000354370.

  12. Koepsell T.D., Monsell S.E. Reversion from mild cognitive impairment to normal or near-normal cognition: Risk factors and prognosis. Neurology. 2012; 79: 1591–98. doi: 10.1212/WNL.0b013e31826e26b7.

  13. Lopez O.L., Becker J.T., Chang Y.F. et al. Incidence of mild cognitive impairment in the Pittsburgh Cardiovascular Health Study-Cognition Study. Neurology. 2012; 79(15): 1599–606, doi: 10.1212/WNL.0b013e31826e25f0.

  14. Patnode C.D., Perdue L.A., Rossom R.C. et al. Screening for cognitive impairment in older adults: an evidence update for the U.S. Preventive Services Task Force. Rockville (MD): Agency for Healthcare Research and Quality (US); 2020. Report No.: 19-05257-EF-1.

  15. Левин О.С. Диагностика и лечение деменции в клинической практике. М: МЕДпресс-информ. 2010; 256 с. [Levin O.S. Diagnosis and treatment of dementia in clinical practice. Moscow: MEDpress-inform. 2010; 256 pp. (In Russ.)]. ISBN: 5-98322-621-5.

  16. Гусев Е.И., Боголепова А.Н. Когнитивные нарушения и деменция. М.: Ремедиум. 2018; 120 с. [Gusev E.I., Bogolepova A.N. Cognitive disorders and dementia. Moscow: Remedium. 2018; 120 pp. (In Russ.)]. ISBN: 9785906499448.

  17. Albert M.S., DeKosky S.T., Dickson D. et al. The diagnosis of mild cognitive impairment due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement. 2011; 7: 270–79. doi: 10.1016/j.jalz.2011.03.008.

  18. Sachdev P., Kalaria R., O’Brien J., et al. Diagnostic criteria for vascular cognitive disorders: a VASCOG statement. Alzheimer Dis Assoc Disord. 2014; 28(3): 206–18. doi: 10.1097/WAD.0000000000000034.

  19. van der Flier W.M., Skoog I. et al. Vascular cognitive impairment. Nat Rev Dis Primers. 2018; 4: 18003. doi: 10.1038/nrdp.2018.3.

  20. Боголепова А.Н. Роль оксидантного стресса в развитии сосудистых когнитивных расстройств. Журнал неврологии и психиатрии им. С.С. Корсакова. 2020; 8: 133–139. [Bogolepova A.N. Role of oxidative stress in the development of cognitive disorders. Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova = Journal of Neurology and Psychiatry named after S.S. Korsakov. 2020; 8: 133–139 (In Russ.)]. doi: 10.17116/jnevro2020120081133.

  21. McCarten J.R. Clinical evaluation of early cognitive symptoms. Clinics in geriatric medicine. 2013; 29(4): 791–807. doi: 10.1016/j.cger.2013.07.005.

  22. Russ T.C., Morling J.R. Cholinesterase inhibitors for mild cognitive impairment. Cochrane Database Syst Rev. 2012; 2012(9): CD009132. doi: 10.1002/14651858.CD009132.

  23. Wang F., Zou Z., Gong Y. et al. Regulation of human brain microvascular endothelial cell adhesion and barrier functions by Memantine. J Mol Neurosci. 2017; 62(1): 123–29. doi: 10.1007/s12031-017-0917-x.

  24. Ilhan Algin D., Dagli Atalay S., Ozkan S. et al. Memantine improves semantic memory in patients with amnestic mild cognitive impairment: A single-photon emission computed tomography study. J Int Med Res. 2017; 45(6): 2053–64. doi: 10.1177/0300060517715166.

  25. Pelton G.H., Harper O.L., Roose S.P. et al. Combined treatment with memantine/es-citalopram for older depressed patients with cognitive impairment: a pilot study. Int J Geriatr Psychiatry. 2016; 31(6): 648–55. doi: 10.1002/gps.4375.

  26. Peters O., Lorenz D., Fesche A. et al. A combination of galantamine and memantine modifies cognitive function in subjects with amnestic MCI. J Nutr Health Aging. 2012; 16: 544–48. doi: 10.1007/s12603-012-0062-8.

  27. Tricco A.C., Soobiah C., Lillie E. et al. Use of cognitive enhancers for mild cognitive impairment: protocol for a systematic review and network meta-analysis. Syst Rev. 2012; 1: 25. doi: 10.1186/2046-4053-1-25.

  28. Levin O., Yunishchenko N., Dudarova M. Efficacy of akatinol memantine in moderate cognitive impairments. Neurosci Behav Physiol. 2010; 40: 926–33.

  29. Левин О.С., Васенина Е.Е., Ганькина О.А. Диагностика и лечение умеренного когнитивного расстройства. Современная терапия в психиатрии и неврологии. 2014; 4: 4–9. [Levin O.S., Vasenina E.E., Gankina O.A. Diagnosis and treatment of mild cognitive impairment. Sovremennaya Therapiya v Psikhiatrii i Nevrologii = Actual Therapy in Psychiatry and Neurology. 2014; 4: 4–9 (In Russ.)].

  30. Боголепова А.Н. Современный взгляд на возможности профилактики деменции. Медицинский совет. 2019; 18: 52–58. [Bogolepova A.N. A contemporary view of the possibilities of preventing dementia. Meditsinskiy sovet = Medical Council. 2019; 18: 52–58 (In Russ.)]. doi: https://doi.org/10.21518/2079-701Х-2019-18-52-58.

  31. Adopting a healthy lifestyle helps reduce the risk of dementia. Available at: https://www.who.int/news/item/14-05-2019-adopting-a-healthy-lifestyle-helps-reduce-the-risk-of-dementia (date of access – 04.05.2021).

  32. Eshkoor S.A., Hamid T.A., Mun C.Y., Ng C.K. Mild cognitive impairment and its management in older people. Clin Interv Aging. 2015; 10: 687–93. doi: 10.2147/CIA.S73922.

  33. Vancampfort D., Stubbs B., Lara E. et al. Mild cognitive impairment and physical activity in the general population: Findings from six low- and middle-income countries. Exp Gerontol. 2017; 100: 100–05. doi: 10.1016/j.exger.2017.10.028.

  34. Middleton L.E., Ventura M.I., Santos-Modesitt W. et al. The Mental Activity and eXercise (MAX) trial: Effects on physical function and quality of life among older adults with cognitive complaints. Contemp Clin Trials. 2018; 64: 161–66. doi: 10.1016/j.cct.2017.10.009.

  35. Tan Z.S., Spartano N.L., Beiser A.S. et al. Physical activity, brain volume, and dementia risk: The Framingham Study. J Gerontol A Biol Sci Med Sci. 2017; 72(6): 789–95. doi: 10.1016/j.mayocp.2016.04.024.

  36. Ambigga D., Suthahar A., Ramli A. et al. Diagnosis and management of mild cognitive impairment in the community: what is the role of primary care physician? Malays Fam Physician. 2011; 6(2–3): 74–78.

  37. Liao Y.Y., Tseng H.Y., Lin Y.J. et al. Using virtual reality-based training to improve cognitive function, instrumental activities of daily living and neural efficiency in older adults with mild cognitive impairment. Eur J Phys Rehabil Med. 2020; 56(1): 47–57. doi: 10.23736/S1973-9087.19.05899-4.

  38. Petersson S.D., Philippou E. Mediterranean diet, cognitive function, and dementia: a systematic review of the evidence. Adv Nutr. 2016; 7(5): 889–904. doi: 10.3945/an.116.012138.

  39. Dzierzewski J.M., Dautovich N., Ravyts S. Sleep and cognition in older adults. Sleep Med Clin. 2018; 13(1): 93–106. doi: 10.1016/j.jsmc.2017.09.009.

  40. 40. Pase M.P., Himali J.J., Grima N.A. et al. Sleep architecture and the risk of incident dementia in the community. Neurology. 2017; 89(12): 1244–50. doi: 10.1212/WNL.0000000000004373.

  41. Goldstein L.B., Bushnell C.D., Adams R.J. et al. Guidelines for the primary prevention of stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011; 42(2): 517–84. doi: 10.1161/STR.0b013e3181fcb238.

  42. Sabayan B., Wijsman L.W., Foster-Dingley J.C. et al. Association of visit-to-visit variability in blood pressure with cognitive function in old age: prospective cohort study. BMJ. 2013; 347: f4600. doi: 10.1136/bmj.f4600.

  43. Gao S., Hendrie H.C., Wang C. et al. Redefined blood pressure variability measure and its association with mortality in elderly primary care patients. Hypertension. 2014; 64(1): 45–52. doi: 10.1161/HYPERTENSIONAHA.114.03576.

  44. Hughes D., Judge C., Murphy R. et al. Association of blood pressure lowering with incident dementia or cognitive impairment: a systematic review and meta-analysis. JAMA. 2020; 323(19): 1934–44. doi: 10.1001/jama.2020.4249.


About the Autors

Anna N. Bogolepova, MD, professor of the Department of neurology, neurosurgery and medical genetics, N.I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of Russia, head of the Department of cognitive disorders, Federal Center of Brain Research and Neurotechnologies of FMBA. Address: 117997, Moscow,
1 Ostrovityaninova Str. Tel.: +7 (495) 434-03-29; +7 (800) 505-09-76. E-mail: annabogolepova@yandex.ru. ORCID: 0000-0002-6327-3546


Similar Articles

Back to Content

Бионика Медиа