Management of patients with cognitive impairment in old age

Cognitive impairment (CI) is one of the most common disorders in elderly. As the population ages, the prevalence of cognitive impairment CI is also increasing. The importance of early identification of individuals with mild CI (MCI) lies in the fact that timely diagnosis of these disorders increases the potential for secondary prevention and therapeutic intervention, which can delay or even prevent the onset of occupational and social maladaptation due to the development of dementia. The current principles of classification of the MCI and the criteria for its diagnosis are presented. Current approaches to the treatment of patients with CI are discussed. It is shown that treatment should start as early as possible and include both non-pharmacological and pharmacological approaches to improve cognitive abilities and prevent CI progression. The possibilities of modern neuroprotective and symptomatic therapy of MCI and the role of choline alfoscerate in the treatment of MCI and dementia are presented. The results of the multicenter placebo-controlled ASCOMALVA study are discussed, in which the addition of choline alfoscerate to donepezil therapy in patients with Alzheimer's disease and cerebrovascular disease helped to slow the progression of CI, reduce the severity of the disease, and had a positive effect on the behavioral functions and emotional status of both patients and their caregivers. In addition, a decrease in the progression of cerebral atrophy was observed. A new form of choline alfoscerate (Cerpechol) for oral administration is reported that may increase patients' compliance and can be used in patients with dysphagia.