Symptoms of cognitive impairment. Moderate Cognitive Disorders What is Cognitive Disorder

Which signals a disorder of the brain. These violations directly affect the ability to intelligently understand the world. And the reasons for this can be a number of different diseases. What is the essence of this pathology?

What are cognitive impairments?

The cognitive properties of the body include such functions of our nervous system, which are responsible for the awareness, perception, study, understanding and processing of information from our environment. Without this important function, a person is not able to correctly perceive and cognize the world around him. The following are the functions that will suffer as a result of this pathology:

• Perception. A person cannot perceive information from the external environment.
• Intelligence. The ability to analyze information is impaired. A person is not able to draw conclusions.
• Psychomotor function. The ability to perform various motor skills is lost.
• Memory. The ability to store and reproduce the information received is impaired.
• Attention. A person with great difficulty can isolate any information from the general flow, he has difficulty concentrating.
• Speech.

Reasons for violations

The causes of cognitive impairment are conventionally divided into two categories: organic and functional.

The latter is characterized by the fact that a person does not have any direct damage to the brain. Stressful situations, overwork, negative emotions can lead to this state. It can be observed in people of all ages and is not particularly dangerous. Symptoms usually go away on their own after the cause of their occurrence is eliminated. Occasionally, there is a need for mild drug therapy.

Brain damage

Organic disorders always mean damage to the brain. These conditions are more common in older people. But competent treatment in most cases will achieve significant improvements even with cognitive impairment in old age.

The most popular causes of the named pathology:

• hypothyroidism;
• diabetes;
• various injuries;
• vascular diseases of the brain - atherosclerosis (leads to occlusion of the great vessels), stroke, arterial hypertension;
• liver failure;
• renal failure;
• irrational consumption of medicines;
• addiction;
• alcoholism;
• a brain tumor;
• multiple sclerosis;
• alzheimer's disease;
• parkinson's disease;
• poisoning.

How does cognitive impairment syndrome manifest itself?

Symptoms

The symptoms of the disease are very diverse. In many ways, they will be determined by the severity of the pathological process and its location in the brain. With cognitive impairment, most often, not one function is damaged, but several at once:

Kinds

Based on the degree of manifestation of violations, three types of them can be designated.

With mild cognitive impairment, the symptoms look like a decrease in concentration, an imperceptible memory impairment, and high fatigue in various types of mental work. A person can forget the names of friends, is unable to find his way in an unfamiliar place, it is difficult for him to choose words. Often he cannot remember where he left something.

Investigations of these disorders are carried out using psychological and clinical research. So, when performing neuropsychological tests, a violation of serial counting can be established. The patient is characterized by the absence of global changes in the emotional and behavioral sphere, there is no damage to the brain. There is a slight violation of professional and

Moderate cognitive impairment is caused by impairment of one or more functions. The patient may need help from outside, as he almost does not remember some situations from life, is unable to find the way.

Dementia

A severe type of cognitive impairment is dementia. This type is characterized by the presence of complex problems in the professional and social spheres and even in banal self-service. He constantly needs outside help. A person becomes disoriented in time, he does not remember many life events. The situation can be complicated by the appearance of obsessions, anxiety, delusions and hallucinations. The most severe manifestation is a complete lack of psychomotor skills, urinary incontinence, loss of speech.

Cognitive impairment in children

This problem is quite common in children and adolescents. Its causes may lie in the deficiency of vitamins and minerals necessary for the body, traumas during childbirth, past diseases, brain hypoxia, intrauterine infections.

It is important to know that the most common cause of cognitive impairment in children is vitamin deficiency. Scientists have conducted a number of studies, as a result of which they found a clear pattern of decreased cognitive functions in children, the cause of which is an insufficient supply of micronutrients.

Typical signs of cognitive impairment in children are attention deficit hyperactivity disorder, unstable psyche, impaired behavioral reflexes, and difficulty in mastering writing and reading skills.

Drugs

Treatment of children with cognitive impairments should be carried out in a complex, including drug and non-drug methods of therapy. Of the drugs, in most cases, nootropics are used. They increase metabolic functions and interneuronal transmission in the central nervous system, which is good for intellectual activity, memory, speech, attention and learning ability. Such funds include Encephabol, Piracetam, Piracetam, Instenon.

The positive effect is also acquired during classes with a psychotherapist, as well as through memory training, for example, memorizing songs and poems.

How to identify cognitive disorders occurring in the brain

In order to detect the presence and degree of cognitive impairment of the brain, it is necessary to interview the patient and his relatives in detail. It is necessary to take into account the presence of trauma in the anamnesis, heredity, the mental and emotional state of the patient, the use of drugs, bad habits.

Neurologists examine the patient for the presence of an underlying disease that can give neurological symptoms.

The mental state will help determine a specialized specialist using a neuropsychological test. Such tests are unique exercises for reproducing words and pictures, solving problems, performing any motor exercises and similar actions.

For cognitive impairment in the elderly, it is very good to use the MMSE scale - this is a list of questions that can assess the position of memory, perception, speech, reading, sketching, orientation in space, etc. This scale can also be used to assess adequacy and effectiveness treatment.

In patients with acquired cognitive impairment, special laboratory tests should be performed. The doctor needs to have data on biochemical and clinical blood tests, levels of thyroid-stimulating hormones, lipid profile and some other indicators.

Of the hardware methods used in this case: electroencephalography, computed and magnetic resonance imaging, Doppler ultrasonography of the great vessels.

The patient needs to eliminate possible somatic diseases.

If there is any suspicion of Alzheimer's disease, differential diagnosis of this disease with vascular dementia should be made.

How is cognitive impairment treated?

Therapies

If you observe even the slightest signs of cognitive impairment in yourself, you need to start using vitamin-mineral complexes and take the amino acid "Glycine". Of course, self-medication is not recommended, so you should consult your doctor before starting any therapy.

Correction of cognitive impairments, of course, will largely depend on the cause of their origin. But its most important goal is to correct pathological changes that occur in the brain. In addition to treating the underlying disease, doctors advise taking neuroprotective agents to increase cognitive function. These include: "Cavinton", "Piracetam", "Nootropil", "Ceraxon", "Cerebrolysin", "Mildronat". It is also a good prevention of further occurrence of this disorder.

If the patient has severe cognitive impairment and identified dementia, he will be prescribed the following drugs: "Nicergoline", "Galantamine", "Memantine", "Rivastigmine", "Donepezil". The duration of the course and the dosage are determined strictly individually.

The patient is also shown drugs that will help to cope with hypercholesterolemia - "Simvastatin", "Torvacard", "Atorvastatin". In addition, doctors recommend a cholesterol-free diet. It is necessary to add vegetables, fruits, low-fat milk, cottage cheese and seafood to the diet. It is also important to give up bad habits, if any. A course of psychotherapy will be helpful.

Additional Information

Doctors advise everyone to study poems, draw, knit, or some other activity where you need to use your hands. Crossword puzzles are also helpful. Such a pastime is a wonderful exercise for the brain.

How can cognitive impairments be prevented?

Prevention and prognosis

It is impossible to make a general prognosis for cognitive impairment. In each case, the results are individual. But if you seek medical help in a timely manner and follow all the instructions, you will be able to slow down the development of the painful process.

It should be noted that there are two forms of cognitive disorders: reversible and irreversible. The first shape can be corrected, but the second cannot.

Prevention includes special interventions that aim to reduce stress and increase mental and physical activity in a person. In order to avoid the appearance of such pathologies, one should try to constantly perform any intellectual tasks from a young age. In addition, in order to prevent dementia, it is necessary to timely treat vascular diseases, liver diseases, as well as replenish the lack of B vitamins.

Treatment of cognitive impairment must be timely.

Most of the cases indicate that the symptoms are only getting worse. So an important goal of prevention is to slow down the further course of destructive processes, to reduce pathological effects on the brain. To do this, you should adhere to certain rules:

• Engage in the various cognitive exercises we mentioned earlier.
• Take medications prescribed by your doctor.
• Maintain a stable mental and emotional state, beware of negative emotions, stress.
• Since there is a connection between cognitive functions and physical activity, you should definitely engage in any kind of sports (gymnastics, swimming, yoga, Pilates, walking).
• One cannot ignore the importance of social activities. People who are socially isolated are at high risk for these disorders.
• You also need to focus on your nutrition. It needs to be balanced. The positive effect will be if you follow the Mediterranean diet. You can take vitamins and nutritional supplements: vitamin E, B vitamins, copper, zinc, omega-3.

Finally

Cognitive impairments are, of course, a very serious health problem. Therefore, it is extremely necessary to detect it at the first stages of its occurrence. This can help in taking adequate measures to prevent disease progression.

Cognitive disorder in a person is a special change that occurs in his cognitive area of \u200b\u200bactivity. They are manifested by a decrease in memory, a deterioration in thinking abilities in comparison with the initial personal level.

Thanks to the cognitive abilities of the brain, a person has the ability to cognize the world around him, to interact with it. Receiving and processing information, which is recorded and stored for a long time, allows you to subsequently effectively use it to achieve the goals set.

Cognitive Disorder Causes

Cognitive impairments are either functional or organic. If there is no direct damage to the brain, they speak of functional disorders.

The causes of cognitive impairment, as a rule, are associated with the presence of overwork, periodic stress, physical and mental stress, and repeated manifestations of negative emotions. Such violations occur at any age. After the elimination of the pathological factor, these disorders are practically leveled out and extremely rarely require drug intervention.

It develops in connection with brain damage after injury or illness. As a rule, people in old age are susceptible to this. The changes are deeper and harder. Correctly selected drug correction can soften and slow down negative processes.

Most often, organic disorders are a consequence of cerebral circulation insufficiency, a decrease in the mass of the brain, its involution (atrophy), which in turn develops with hypertension, vascular diseases accompanied by chronic cerebral ischemia, after. Timely diagnosis and indicated therapy of these diseases is the prevention of complications that arise.

Atrophic processes that take place in the brain, and that increase with age, lead to more pronounced impairments of cognitive abilities. This condition is known as Alzheimer's disease and has a progressive course. The degree of deterioration in the state of mental function varies greatly, its decline can occur extremely slowly and patients retain the ability to live independently for a long time.

Today, it is possible to achieve a stable condition of the patient thanks to new methods of treatment. Such disorders can be caused by abnormalities in the brain, metabolic disorders, internal diseases, excessive alcohol consumption, and poisoning.

Symptoms of cognitive impairment

Symptoms of cognitive impairment are determined by the severity of the process and the localization of brain disorders. Most often, several or all functions are affected.

Patients demonstrate poor memory, low mental endurance, cannot clearly express their thoughts, concentrate attention, there are difficulties in counting, and orientation in unfamiliar terrain is disturbed. Loss of self-criticality is noted.

Weakening of memory is manifested by a progressive impairment of remembering current or close events, then the memory of old events is lost. A decrease in the activity of thinking is expressed in helplessness when it is required to analyze information, generalize data, and draw conclusions from them. The inability to concentrate sharply complicates the solution of specific tasks.

Mild cognitive impairment

Mild cognitive impairment is understood as a disorder of the higher functions of the brain, which is caused by vascular disorders. This is the so-called vascular dementia, which begins with mild changes in the cognitive sphere, primarily memory, and can progress to dementia. Clinical symptoms include decreased memory, attention, rapid fatigue, and learning disabilities.

At the same time, there are no atrophic processes in the brain, and such disorders are called cerebrasthenic syndrome, in which patients remain relatively intact. Violations are diagnosed based on the results of clinical and psychological studies. The difference from organic disorders is the lack of emotional, behavioral and productive changes.

Moderate to severe cognitive impairment

If there is a deterioration in one or more cognitive processes, which is outside the normal range for a given age, but does not reach the degree of dementia, then we speak of moderate cognitive impairment. It occurs in 20% of people over 65 years of age. In the next 5 years, 60% of them develop dementia. Approximately 20-30% of patients show a stable or slowly deteriorating process of cognitive decline. If several symptoms occur over a short period of time, specialist help is needed.

Severe forms of cognitive disorders in humans include those in which serious problems arise in professional and social activities, self-care. To diagnose disorders, the method of neuropsychological testing is used, which makes it possible to detect the presence and nature of the severity of cognitive impairments. In the early period of onset, such disorders are well corrected with medication and various psychological techniques.

Cognitive impairment in children

Recently, a connection has been traced between cognitive impairments in childhood and insufficient intake of vitamins and microelements into the child's body. The lack of raw, thermally unprocessed, unrefined foods in the diet of a modern child leads to a deficiency of these important substances for health.

The functions of memory, intensity of thinking, clarity, concentration, learning, etc. depend on the saturation of the body with vitamin C and B vitamins.

These problems occur in almost 20% of children and adolescents. Difficulties in writing and reading, hyperactivity with lack of attention, emotional instability, and behavioral disorders are common.

The reasons may also be previous diseases, such as brain hypoxia, birth trauma, intrauterine infections, as well as some metabolic disorders, degenerative mental diseases. The earliest possible detection of pathology contributes to the effective prevention of disability in these children.

Cognitive disorders treatment

Treatment of cognitive disorders is selected individually, largely determined by the causes that led to cognitive disorders and the degree of their severity. Drugs that inhibit acetylcholinesterase in the brain are widely used.

In addition to drug correction, psychotherapy of such patients is used, aimed at developing the ability to change their behavior and thoughts. The main task is to teach the patient an adaptive response to negative thoughts, self-deprecation.

It is also recommended to train your memory with special exercises, such as memorizing poems. The gradual complication of tasks, constant assessment of ongoing changes in a person's personality, improvement of adaptation to stress, constant support of the psychotherapist give the patient a chance to adapt to the ongoing changes.

Under the term " mild cognitive impairment»Understand impairments of one or more cognitive functions that go beyond the age norm, but do not reach the severity of dementia. “If you have reached old age and do not notice any signs of senile dementia in yourself, then the first sign is already there” (T. Oizerman). The syndrome of moderate cognitive impairment in most cases is a pathological condition, as a result of which the changes at this stage are not limited to age-related involutive processes. In most cases, it is associated with an incipient brain disease (repeats the etiology of dementia).

According to a number of researchers, the syndrome of mild cognitive impairment is observed in 15-20% of people over 65 years of age. Long-term observations indicate that within 5 years, dementia develops in 60-80% of patients with this pathology. In 20-40% of cases, mild cognitive impairment is stable or slowly progressive (i.e., does not progress to dementia).

Currently, there are three main clinical variants of the disease.

(R. Peterson, 2001):

The main symptoms mild cognitive impairment are:

Below are the modified diagnostic criteria syndrome of mild cognitive impairment (S. Guatheir et. al., 2004):

cognitive impairment, according to the patient and / or his immediate family;

Currently, the term "mild cognitive impairment" is included in the latest revision of the international classification of diseases (ICD-10) as an independent diagnosis:

The prognosis in the presence of the syndrome of mild cognitive impairment is quite serious. Thus, the risk of death is 1.7 times higher and the risk of Alzheimer's disease is 3.1 times higher. Unfavorable prognostic signs with moderate cognitive impairment are:

According to Y. Stern et al. (1992) for the development of dementia in persons with higher education, more significant organic changes are necessary (proverb: “ It's never too late to learn »).

How unpleasant it is to note in yourself or loved ones a deterioration in the ability to memorize information, the appearance of rapid fatigue, a decrease in intelligence. Such disorders in the work of the brain in medicine are called "cognitive impairments". However, one should not despair. Adequate therapy is of great importance for people with this disease. Modern medicine is able to provide proper treatment and achieve stable remission.

What is cognitive impairment

Cognitive functions are perception, intelligence, the ability to get acquainted with new information and remember it, attention, speech, orientation in space and time, motor skills. Over time, a person begins to show violations of daily behavior due to disruptions in the work of cognitive functions. Isolated cases of forgetfulness are not yet a reason to worry, but if a person begins to regularly forget events, names or names of objects, then this may indicate disturbances in brain activity, then the patient needs the help of a neurologist.

Symptoms

If the impairment of cognitive functions is associated with the left hemisphere of the brain, then one can observe such external symptoms as the patient's inability to write, count, read, difficulties with logic and analysis begin, and mathematical abilities disappear. The right hemisphere, affected by the disease, will give spatial disturbances, for example, a person ceases to navigate in space, the ability to dream, compose, fantasize, empathize, draw and other creativity goes away.

The activity of the frontal lobes of the brain is associated with the perception of smells and sounds, with the emotional coloring of the surrounding world, it is responsible for experience and memorization. If the disease affects the parietal lobes of the brain, then the patient loses the ability to purposefully perform actions, he does not distinguish where is right, where is left, he cannot write or read. The occipital lobes are responsible for the ability to see color pictures, analyze, recognize faces and objects. Changes in the cerebellar region are characterized by inappropriate behavior and speech impairment.

Mild cognitive impairment

It can be considered the initial stage in the chain of failures in higher brain activity, which mostly concern the patient's memory. A mild type of violation can be provoked not only by age-related changes. Encephalitis or head trauma is often the cause. What is cognitive disorder and how does it manifest externally? This is severe fatigue during mental activity, the inability to memorize new information, confusion, difficulty concentrating, problems when performing purposeful actions.

Often it is difficult for the patient to understand someone else's speech or to choose words to convey thoughts himself. An interesting fact is that this is a reversible process. With strong mental stress, the symptoms progress, and after a good rest they disappear. However, there is a need to visit a neurologist and a therapist, who will conduct the necessary instrumental studies, and prescribe a test.

Moderate cognitive impairment

With the deterioration of the work of several processes that go beyond the norm for the patient's age, but do not reach the degree of dementia, we can talk about a moderate violation. According to medical statistics, similar symptoms can occur in 20% of people over the age of 60. However, most of these patients develop dementia over the next five years. In 30% of people, a slow progression of the disease is observed, but if a disorder of several cognitive functions occurs in a short period of time, an urgent specialist consultation is necessary.

Severe form

The prevalence of dementia is observed in elderly patients, and it is usually provoked by Alzheimer's disease. AD is a brain disease associated with the death of acetylcholinergic neurons. Its first signs are loss of memory, constant forgetfulness of life events. At the next stage of the progression of pathological changes, disorientation in space begins, a person loses the ability to express his thoughts, says delirium, in everyday life he becomes helpless and may need the help of loved ones.

Often, pronounced impairments of cognitive functions are provoked by cerebrovascular insufficiency, then the memory for life events can remain good, but the intellect suffers. Patients cease to distinguish and see the similarity between concepts, their thinking slows down, and difficulty in concentrating. In addition, a person has an increase in muscle tone, gait changes. With such signs, a neuropsychological examination is prescribed.

The reasons

Violations are divided into two types: functional and organic. Functional disorders are provoked by emotional overstrain, stress, overload. They are typical for any age and, when the causes are eliminated, they usually go away on their own. However, there are times when a doctor decides to use drug therapy.

Organic disorders are provoked by changes in the brain under the influence of any disease. As a rule, they are observed in old age and are characterized by a stable character. Modern medicine offers productive ways to solve this problem, allowing you to get a good result. The following reasons for violations can be named:

• Insufficient blood supply to brain cells. This includes diseases such as cardiovascular disease, stroke, hypertension. A person must monitor his blood pressure, maintain optimal sugar and cholesterol levels.
• Age-related brain atrophy or progressive Alzheimer's disease. In this case, the symptomatology of the disease grows gradually, over many years. Adequate treatment will help improve the patient's condition and stabilize the symptoms for a long time.
• Metabolic problems.
• Alcoholism and poisoning.
• Cardiovascular insufficiency.

In children

The practice of childhood neuralgia shows that cognitive deficits appear due to diseases affecting the nervous system of a young patient. This can be, for example, birth trauma or intrauterine infection, congenital metabolic disorders in the child's nervous system. There is a problem of prompt and correct diagnosis, but the sooner the specialists identify the disease and begin to conduct adequate therapy, the better the result will be.

Cognitive disorders in old age

In elderly patients, the brain undergoes a lot of changes, and its mass decreases significantly. This process begins early, at the age of 30-40, and by the age of 80, the degree of neuronal loss can be up to 50% of the total mass. Surviving neurons do not remain the same, they undergo functional changes. Externally, this can manifest itself, including in the form of impaired cognitive functions.

Cognitive dysfunction in the elderly is expressed in excessive irritability, resentment, limited thinking, poor memory. Their mood often changes, such qualities as pessimism, fear, anxiety, dissatisfaction with other people are manifested, social and household maladjustment is possible. Lack of treatment will lead to catastrophic cognitive impairment.

Classification

The modern classification of cognitive disorders is based on their severity and is divided into mild, moderate and severe forms. With mild disorders, such processes as the ability to quickly process incoming information, switching from one type of activity to another, come under attack. In moderate disorders, memory impairment predominates, which over time can develop into Alzheimer's disease. Severe disorders are disorientation in time, speech suffers, the ability to reproduce words is impaired, and the psyche suffers.

Diagnosis of cognitive impairment

It is based on the subjective complaints of the patient himself, on the assessment of his condition by close people and the determination of the neurological status. In addition, the doctor conducts neuropsychological testing, prescribes such types of research as computed and magnetic resonance imaging. To diagnose the presence of depression in a patient (it often becomes the cause of the development of cognitive disorders), the Hamilton scale is used.

Treatment

Cognitive personality disorder is treated with three types of neurometabolic drugs: classic drugs (Piracetam, Pyritinol, Cerebrolysin), drugs for the treatment of Alzheimer's disease (Halina alfoscerat, Memantine, Ipidacrine), combined drugs (Omaron, Cinnarizin). A wide range of neurometabolic drugs for the regulation of cognitive processes makes it possible to individualize the treatment of patients with cognitive impairment.

Prevention

What should be done to avoid the onset of cognitive impairment? From a young age, you need to take care of your health. Doctors recommend daily active sports, memory training, and more communication as a prevention of this problem. A huge role is played by rejection of bad habits, adequate intake of vitamins, proper nutrition. For example, a Mediterranean diet can help reduce the risk of disorder. Recently, phytopreparations from ginkgo biloba have been used for prevention.

Video

Attention! The information presented in the article is for informational purposes only. The materials of the article do not call for self-treatment. Only a qualified doctor can diagnose and give recommendations for treatment, based on the individual characteristics of a particular patient.

Discuss

Cognitive disorders of the brain

Many people know that impaired blood circulation in the vessels of the neck and head is one of the main risk factors for the development of acute stroke, which has serious consequences for the health and life of patients. Meanwhile, much more often dyscirculatory problems cause changes that are not obvious at first glance: a progressive decrease in memory and the ability to concentrate, as well as other disorders of cognitive function.

Why cognitive impairments develop in vascular diseases of the brain, how they are manifested, diagnosed and treated: we will analyze in our review and the video in this article.

The brain began to cope with its work worse - perhaps this is a sign of illness

The essence of the problem

The most complex brain functions associated with:

• the process of rational cognition of the surrounding world;
• purposeful interaction with available objects, phenomena and living beings;
• perception (collection, receipt) of information;
• processing and analysis of the received data;
• memorization and storage in memory;
• exchange of information;
• construction and sequential execution of sequential actions, assessment of their results.

Thus, cognitive impairment is associated with a decrease in these functions relative to the initial level (individual norm).

Note! Each person has their own level of development of cognitive abilities, due to genetic characteristics. So, someone can boast of a phenomenal memory, while someone has difficulty memorizing a simple quatrain. There are no generally accepted norms for assessing cognitive function.

There are more than twenty pathologies accompanied by impaired cognitive functions. Vascular diseases occupy an important place among them.

Common causes of cognitive decline are:

• ischemic stroke (heart attack)the brain of certain localizations (see);
• multi-infarction condition;
• chronic ischemia of nerve tissues -discirculatory encephalopathy, vascular dementia;
• consequences of subarachnoid or intraventricular hemorrhage;
• dysmetabolic (mixed vascular-dysmetabolic) encephalopathy -hepatic, renal, hypoglycemic, etc.

Unfortunately, most chronic vascular diseases cause irreversible cognitive impairment. In some cases (for example, with successful treatment of acute cerebrovascular accident, correction of metabolic disorders), their full or partial recovery is possible.

What disorders are more common with CVD?

So, what cognitive impairment is provoked by a violation of the tone of the cerebral vessels? Depending on the severity, they are divided into light, medium and heavy.

Mild degree

An easy degree of impairment is characterized by the preservation of indicators of psychometric scales at the level of the average age norm. However, patients notice a decrease in the ability to remember, concentrate and analyze information and often show concern about this.

Note! Impairment of short-term memory and absent-mindedness are one of the first symptoms of chronic cerebrovascular diseases, which are accompanied by impaired cerebral vascular tone.

Despite the complaints of patients, mild cognitive disorders:

• invisible to others;
• do not cause difficulties in everyday life and at work;
• do not affect the quality of life of patients.

Moderate degree

Moderate disorders are accompanied by the appearance of complaints of high fatigue during mental stress, a pronounced decrease in memory, attention and learning ability.

With this form of cerebral circulatory insufficiency, signs of a disorder of cognitive function:

• are reflected in the patient's complaints;
• visible to others;
• hinder the performance of complex intellectual tasks.

Note! According to statistics, this form of pathology is determined in 12-17% of the elderly population of the world.

Severe degree

The severe degree of cognitive impairment, which was provoked by a violation of the vascular tone of the brain, is called vascular dementia. It occurs in 15-20% of all cases of cognitive decline, ranking three times after dementia in Alzheimer's disease and other degenerative diseases of the nervous system.

Dementia is an acquired mental disorder that is accompanied by a pronounced decrease in intelligence and complete social maladjustment of the patient.

The disease is accompanied by a complex disorder of cognitive functions, including:

• memory - the ability to perceive and reproduce the information received;
• attention;
• speech;
• gnosis - the ability to recognize objects by perception with the help of the senses;
• praxis - the ability to perform targeted movements;
• thinking;
• ability to plan;
• ability to make decisions;
• ability to control own labor and the actions of others.

Note! Unlike mental retardation, which manifests itself from birth, signs of dementia increase gradually, more often in old age.

It is manifested by a slowdown and rigidity of all mental processes. Patients experience difficulties even with simple everyday tasks (grocery shopping, cooking). Mnestic disorders are primarily expressed in a decrease in the ability to learn, later there is a violation of memory for past and current events.

More than 50% of patients are faced with emotional "incontinence" - weakness, tearfulness, irascibility. Many of them have clinical manifestations of depression.

In addition to cognitive disorders, the clinical picture of vascular dementia is often accompanied by the development of neurological deficits. The main syndromes of brain tissue damage are presented in the table below.

Table: Neurological syndromes in severe cognitive impairment:

In addition, paralysis and paresis of the limbs, impaired control of pelvic functions (urinary incontinence, fecal incontinence) are possible. Patients with vascular dementia often lose self-care skills and need constant care.

Methods for the diagnosis of cognitive impairment

Cognitive disorders are diagnosed by a neurologist.

The standard instruction is to use the following minimum survey scope:

1. Collection of complaints and anamnesis (from the words of the patient and relatives).
2. General neurological examination.
3. Neuropsychological testing.
4. Instrumental data (CT / MRI (see)).
5. Screening tests:

• "5 words";
• schulte test;
• clock drawing test;
• a short scale for assessing mental status.

Treatment principles

The main role in the correction of cognitive disorders in CVD is assigned to the elimination of vascular risk factors. All patients are advised to follow a rational diet, give up bad habits, and be physically active. Control of blood pressure, glucose and cholesterol concentration in the blood is of no small importance.

If cognitive impairment occurs after an acute cerebral stroke, the appointment is indicated:

• antiplatelet agents (Thrombo-Ass, Ticlopidine, Clopidogrel, Dipyridamole);
• indirect anticoagulants;
• antihypertensive drugs.

To improve cognitive functions, it is important to regularly train your memory by memorizing poetry and solving crosswords.

Additionally, medications can be prescribed:

• Piracetam;
• Galantamine;
• Donepizil;
• Vinpocetine;
• Gliatilin, etc.

The selection of a specific drug is determined by the severity and nature of cognitive impairment, the presence of concomitant pathologies, and the patient's tolerance of certain drugs.

With rare exceptions, cognitive impairment is a problem in old age. To avoid loss of memory, attention, learning ability and almost complete lack of independence in old age, it is important to lead a healthy lifestyle, eat right, be physically active and regularly exercise the brain.

Good results in the prevention of a decrease in cognitive functions are also obtained by timely treatment of circulatory disorders in the cerebral vessels.