Mild cognitive impairment due to cerebrovascular disease and Alzheimer’s

Cognitive impairment (CI) is one of the most common causes of disability in the elderly. For several years before dementia develops, it is often preceded by mild cognitive impairment (MCI), which is characterized by reduced memory and/or other cognitive functions without significant decline in daily activities. The most common causes of MCI are Alzheimer’s disease (AD), cerebrovascular disease, or a combination of both. Vascular cognitive impairment caused by cerebral microangiopathy is typically represented by non-amnestic MCI subtypes, whereas AD usually presents as a single-domain amnestic subtype. To establish AD as the cause of MCI, biological markers in the cerebrospinal fluid (CSF) can be used, such as low Aβ 42 levels, elevated Aβ 40 /Aβ 42 ratio, increased total and phosphorylated tau protein levels, and positron emission tomography (PET) indicating pathological accumulation of beta-amyloid and tau protein in the brain. This paper presents case reports of patients with MCI, in whom analysis of AD biomarkers made it possible to diagnose AD in one patient and vascular MCI in another. Prevention of cognitive decline progression involves the correction of vascular risk factors and maintaining regular physical and cognitive activity. In recent years, the efficacy of anti-amyloid monoclonal antibodies has been demonstrated in patients with MCI due to AD. The results of multicenter placebo-controlled trials of the drug Prospekta in vascular cognitive impairment are discussed. Currently, early diagnosis and effective treatment of MCI represent one of the most important areas in neurology.