Opportunities for differential diagnosis of vascular cognitive impairment and Alzheimer's disease at the predementia stage

The steadily increasing aging of the population is accompanied by a growing prevalence of cognitive impairment (CI) of varying severity. The main causes of CI are Alzheimer's disease (AD), vascular impairment, and their combination. It has been shown that establishing the exact etiology of CI is crucial for appropriate patient management and disease prognosis. The paper outlines current principles for the diagnosis and treatment of mild cognitive impairment (MCI) syndrome. It is demonstrated that the nosological structure of MCI generally corresponds to the etiology of dementia in the elderly. Early detection of CI at the MCI stage is important because timely diagnosis broadens the potential for secondary prevention and therapeutic intervention, which can delay or even prevent the onset of dementia. A clinical observation is presented of a female patient with a polyfunctional amnestic type of MCI syndrome, with both vascular and neurodegenerative mechanisms considered as potential etiological factors. Examination of the cerebrospinal fluid revealed biomarkers of AD, which enabled a diagnosis of late-onset AD at the predementia stage. The paper also analyzes the capabilities of modern neuroprotective and symptomatic therapies for CI, and the role of choline alfoscerate and citicoline in CI treatment. he discussion includes ways to improve patient adherence to CI treatment using newly available dosage forms such as Noocil (240 ml bottle, oral liquid form of citicoline) and Cerpehol (240 ml bottle, oral liquid form of choline alfoscerate), which can also be used in patients with swallowing difficulties.