Cognitive function concept disorders and their causes. Mild cognitive impairment

The degree of their expression lies. Cognitive disorders are divided into mild, moderate and severe.

Mild cognitive impairment

Usually they are neurodynamic in nature. RAM, information processing speed, and the ability to quickly switch from one type of activity to another suffer.
With mild disorders, complaints of absent-mindedness, decreased memory, attention, and performance appear.

Memory decreases for current events, last names, first names, phone numbers. Professional - does not suffer for a long time.
At first, the changes are not noticeable to others.
With neuropsychologists And scientific research reveals
minor difficulties: slower completion of tasks, impaired concentration.
Cognitive failure is not specific in nature and is predominantly mnestic.
What we call “age-related” changes (in old age).
In people of other age categories, similar symptoms can occur with chronic stress, prolonged physical and mental overload, health problems (arterial hypertension, diabetes, etc.).
In most cases, they are reversible and, with timely, adequate therapy, optimization of lifestyle and work activity, decrease or disappear completely.

Moderate cognitive impairment

They have a polyetiological nature and are not associated with age. Typically, they reflect the onset of diseases leading to dementia.
Timely detection of the moderate stage allows for measures to be taken to prevent the progression of the disease.

Variants of mild cognitive impairment syndrome

With the amnestic variant memory impairment for current events predominates. The problem is progressive and, over time, can become the onset of Alzheimer's disease.

At Multiple cognitive impairment
several cognitive functions are affected - memory, spatial orientation, intelligence, praxis, etc. This type of disorder is typical for discirculatory encephalopathy , Parkinson's disease , frontotemporal dementia.

Impaired cognitive functions with intact memory
This variant usually occurs with a predominance of speech or praxis impairment. It is observed in neurodegenerative diseases - primary progressive aphasia, corticobasal degeneration, dementia with Lewy bodies.

The earlier the syndrome of moderate cognitive impairment is recognized, the more successful the treatment results will be, which will allow you to maintain a decent quality of life for as long as possible.

Severe cognitive impairment

This is dementia. If it occurs against the background of cerebrovascular diseases, or as a result of disturbances in systemic hemodynamics, then it is called vascular.
It is characterized by a violation of such higher mental functions as speech, orientation in space and time, the ability to abstract, and praxis.
Memory and intelligence are most affected, leading to difficulty in daily life.
Almost always the disease is accompanied by emotional and volitional disorders.
Vascular dementia is characterized by a combination of cognitive disorders with focal neurological symptoms - hemiparesis, coordination disorders, statics, etc. (but this is not necessary).
To establish the vascular cause of dementia, it is necessary to have data on damage to the blood vessels of the brain and to establish a temporary and cause-and-effect relationship between dementia and vascular damage to the brain.
For example, if cognitive decline occurred immediately after stroke (usually in the first 3 months), then there is a high probability that they arose precisely due to a vascular cause.
Cognitive deficits can be caused not only by the stroke itself, but a stroke often aggravates existing cognitive problems that have arisen against the background of degenerative changes in the brain: there are two processes that occur together and mutually aggravate each other. With dementia, a person needs constant assistance and care.
It is important to identify the syndrome of cognitive disorders in the earliest period; this will help to timely determine the cause of the disorders and take measures to prevent the worsening of the disease.

One of the characteristics of man that separates him from the animal world is the ability to cognize, understand and interpret the world around him. A person’s ability to think, remember, reason, understand, and reproduce makes him a separate branch in the animal world.

However, cognitive personality disorders can worsen these properties, which will manifest themselves in various symptoms. Treatment is carried out based on the reasons that led to the pathology.

What are cognitive disorders?

What is meant by cognitive disorders on the mental health website? These are disturbances in the structure or functioning of the brain, when it is not able to understand, remember, study, cognition, realize, perceive and process information. Thus, cognitive disorders lead to an inadequate perception of the world, which entails many consequences:

1. Attention suffers if it is unable to concentrate on one thing, that is, to isolate particulars from the general flow.
2. Perception suffers, which is now not carried out, in other words, the person does not receive information from the outside.
3. The functionality of memory, the main tasks of which is the perception and reproduction of information, is impaired.
4. Psychomotor functions are impaired, that is, the ability to perform actions that were previously learned, for example, writing, drawing or driving a car.
5. Intelligence decreases significantly, so a person becomes unable to analyze information and draw conclusions.

Speech especially suffers, since it is not given to a person from birth. If a person cannot perceive speech, then he is not able to assimilate it and reproduce it himself. At a certain stage, a person either does not learn to speak or does not become able to express it, since he will not even understand what other people are saying to him.

There are many forms of cognitive impairment, depending on which area of ​​the brain is affected and which cognitive function is impaired. Often, cognitive impairment occurs in combination. We are talking about damage to the brain that is congenital, traumatic, or acquired as a result of painful lesions.

Causes of cognitive disorders

To treat cognitive disorders, you need to know the causes of their occurrence. Some of them can be eliminated, while the rest remain with the person forever. Conventionally, the reasons are divided into functional and organic:

1. Functional causes are not dangerous, but with prolonged exposure to a person they lead to disorders. They can be overwork, emotional stress, negative, constant. Depending on their duration, the treatment process takes one or another amount of time. In this case, the processes are reversible. Sometimes it is enough to eliminate only the causes, and sometimes drug treatment is required.
2. Organic causes occur due to obvious damage to the brain as a result of various diseases. In some cases, the processes are reversible if treatment is prescribed early. Therapy is always assumed to be medical. Frequent organic causes are circulatory disorders, age-related changes and atrophy.

A person, especially an elderly person, should closely monitor their health. Any disturbances in the functioning of the vascular and cardiac systems inevitably lead to pathologies in the functioning of the brain. In old age, numerous headaches develop, which are accompanied by a number of symptoms, including cognitive disorders. For example, which destroys a person’s personality every year and has no cure.

Other reasons for the development of cognitive disorders may be:

• Vascular diseases of the brain: strokes, atherosclerosis, arterial hypertension.
• Hypothyroidism.
• Alzheimer's and Parkinson's diseases.
• Alcoholism.
• Multiple sclerosis.
• Kidney failure.
• Tumor in the brain.
• Addiction.
• Liver failure.
• Injuries.
• Drug abuse.
• Diabetes mellitus.
• Poisoning.
• Violation of metabolic processes.

Symptoms of cognitive disorder

The symptoms of cognitive disorders depend on the severity of the disease, as well as the area of ​​brain damage. Often there is damage to several areas at once, which leads to extensive disorders.

In general, symptoms of cognitive impairment are accompanied by:

1. Decreased mental performance.
2. Difficulties in understanding other people's words and expressing one's own thoughts.
3. Memory impairment.
4. Deterioration of concentration.

In severe conditions, patients do not care about anything, since they are absolutely uncritical of their own health.

The cognitive sphere is marked by memory deterioration. First, a person forgets recent events, and then completely forgets his life. Mental activity and thinking deteriorate, which is why a person ceases to adequately perceive information, analyze it, and draw conclusions. The individual also becomes unable to concentrate, causing him or her to be unable to perform specific tasks.

Moderate cognitive impairment refers to impairments that go beyond age, but are not marked by full-blown dementia. 20% of patients over 65 years of age suffer from cognitive disorders, of which only 60% suffer from severe dementia. In 30% of cases, symptoms are stable and slowly progressive. Therefore, an individual may not even notice how the disease is progressing in him. However, if a disease is detected, you should consult a doctor.

In the early stages, mild cognitive impairment is easily treated with medication. To identify them, you should pay attention to the following symptoms:

1. Difficulty repeating information just received.
2. Difficulties in performing counting operations.
3. Difficulty remembering names.
4. Disorientation in an unfamiliar area.
5. Difficulty finding words during communication.

Mild cognitive impairment

A mild form of cognitive impairment is called pre-dementia, which is characterized by the following symptoms:

1. Some memory impairment.
2. Decreased concentration.
3. Fatigue during intellectual activity.
4. Forgetfulness of familiar names.
5. Disorientation in an unfamiliar area.
6. Difficulty finding words.

At the same time, there are no atrophic processes in the brain. In behavior and at the level of emotions, a person continues to remain himself. Difficulties in professional and social activity are noted.

The opposite form of cognitive impairment is severe, which is dementia. Here a person experiences obvious difficulties in the social and professional spheres, he loses self-care skills, and therefore needs outside help. The person becomes anxious, hallucinations, obsessive thoughts and delusions appear. The patient gets lost in time and forgets the events of the past. In the most severe cases, urinary incontinence, loss of speech, and forgetting of psychomotor skills develop.

Cognitive disorder in children

Experts associate the appearance of cognitive disorders in children with a deficiency of vitamins, which are now almost difficult to obtain through food. Modern food is rich in various dyes and flavorings. Many dishes consist of ingredients of non-natural origin. Going through prolonged heat treatment also contributes to the destruction of vitamins.

About 20% of children and adolescents suffer from various forms of cognitive disorders:

• Between 5 and 20% suffer from various language disorders and are unable to read or write.
• About 17% of patients are unable to perceive sound information.
• Hyperactivity is observed in 7%.

Mental activity, behavior and the emotional sphere also suffer. Other causes of the development of cognitive disorders include various brain lesions as a result of diseases, congenital pathologies, and degenerative diseases.

Treatment is carried out by a doctor who prescribes nootropic drugs that help improve signal transmission to the brain and metabolic processes. Among them are Piracetam, Encephabol and Instenon. Psychotherapy and memorization of poems and songs are also practiced.

How to treat cognitive disorders?

Cognitive disorders are among the most common. Moreover, they appear in various forms. Treatment depends on the causes of the disorder, the severity, and the characteristics of the manifestation. First, diagnosis is carried out by interviewing the patient’s relatives, conducting tests together with the patient, and identifying characteristic symptoms.

For mild forms of cognitive impairment, a conversation with a neuropsychologist is sufficient, but for severe forms, you can simply note the corresponding signs of the disease. Prescription of medications and therapy depends on the disorder. Thus, centrally acting acetylcholinesterase inhibitors are prescribed. Cognitive psychotherapy, consultations and training are used to improve mental function.

Forecast

Forecasts are made depending on the severity of the disease, the timeliness of a person’s visit to doctors, and the reasons for the development of the disease. Some factors can be prevented and reversed. However, if pathologies are congenital or organic, then sometimes the processes are irreversible.

Doctors treat in any case. However, people are advised to take preventive measures that will protect them from developing such complications:

1. Eat right. You need to constantly saturate your body with all useful microelements and vitamins.
2. Treat cardiovascular diseases and brain diseases in a timely manner.
3. Engage in intellectual activity, constantly train memory, thinking, attention.
4. Note certain deviations and find the reasons for their occurrence.
5. Eliminate stress and emotional turmoil, which also affect mental activity.
6. You should engage in physical exercise and sports, which generally improve your overall health, in particular, help speed up blood circulation.

Cognitive disorders have a significant impact on a person's quality of life. If irreversible processes start, then the disease will progress, which will make the person asocial and helpless.

A cognitive disorder in a person is a special change that occurs in his cognitive area of ​​activity. They are manifested by a decrease in memory, a deterioration in thinking abilities compared to the initial personal level.

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

Causes of Cognitive Disorder

Cognitive impairment is characterized by either a functional or organic nature. If there is no direct damage to the brain, they speak of functional disorders.

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

Develops due to brain damage after injury or illness. As a rule, people in old age are susceptible to this. The changes are deeper and more difficult. Correctly selected drug correction can soften and slow down negative processes.

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

Atrophic processes that occur in the brain, and intensify 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 mental function varies greatly; its decline can occur extremely slowly and patients retain the ability to live independently for quite a long time.

Today it is possible to achieve a stable patient condition thanks to new treatment methods. 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 location of brain disorders. Most often, several or all functions are affected.

Patients demonstrate poor memory, low mental stamina, cannot clearly express their thoughts, cannot concentrate, have difficulty counting, and are disoriented in unfamiliar areas. There is a loss of criticality towards oneself.

Memory loss is manifested by a progressive impairment of remembering current or nearby events, then memory of ancient events is lost. A decrease in the activity of thinking is expressed in helplessness when it is necessary to analyze information, summarize data, and draw conclusions from them. The inability to concentrate makes it extremely difficult to solve specific problems.

Mild cognitive impairment

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

In this case, there are no atrophic processes in the brain, and such disorders are called cerebrasthenic syndrome, in which patients remain relatively safe. Violations are diagnosed based on the results of clinical and psychological studies. The difference from organic disorders is the absence of emotional, behavioral and productive changes.

Moderate to severe cognitive impairment

If there is deterioration in one or more cognitive processes that is beyond the normal range for a given age, but does not reach the level of dementia, then mild cognitive impairment is said to exist. It occurs in 20% of people over 65 years of age. Over the next 5 years, 60% of them develop dementia. Approximately 20-30% of patients exhibit stable or slowly worsening cognitive decline. If several symptoms occur in a short period of time, the help of a specialist is needed.

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

Cognitive impairment in children

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

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

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 causes may also be previous diseases, such as brain hypoxia, birth injuries, intrauterine infections, as well as some metabolic disorders and degenerative mental diseases. Detection of pathology as early as possible contributes to effective prevention of disability in such children.

Treatment of cognitive disorders

Treatment of cognitive disorders is selected individually and is 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 for 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 and self-humiliation.

It is also recommended to train your memory with special exercises, for example, memorizing poems. Gradually increasing the complexity of tasks, constantly assessing ongoing changes in a person’s personality, improving adaptation to stress, and constant support from a psychotherapist give the patient a chance to adapt to the changes taking place.

What is cognitive impairment

Cognitive impairment is a syndrome that characterizes disorders of higher nervous functions of a person, which include: thinking, memory, orientation in space and time, the ability to perform complex motor actions and manipulations, speech, perception of information and others. Functions that distinguish humans in abilities from other mammals.

Cognitive functions- this is the very bridge that connects a person with realization in modern human society. Starting from the performance of complex high-tech operations, be it the control of an engineer of a large automated production, the performance by a surgeon of complex surgical interventions, and ending with ordinary self-care skills in everyday life - everything happens with the help of the higher nervous activity of the brain.

It is expressed in the perception of information, its analysis, transmission and other actions that guide a person’s actions at the moment. Therefore, for full-fledged life, it is necessary that these cognitive functions are performed by our brain at the proper level.

Cells of the cerebral cortex are responsible for cognitive functions, and the mass of these cells decreases with age, therefore cognitive impairment most often occur in older people.

The more progressively the saturation of nerve cells with oxygen and nutrients is disrupted, the faster their functions, which are the basis of cognitive impairment, are disrupted. About cognitive impairments and what they are written above, now we come to our next section - what kind of cognitive impairments are there and how they are determined.

Cognitive impairments in clinical practice are divided by degree of severity: mild, moderate and severe. The severity of these disorders can be determined using special tests or scales used by doctors. An example of such testing is determining cognitive impairment according to the MMSE scale.

The test taker answers questions and performs certain tasks; each task is scored and the severity of cognitive impairment is determined based on the sum of points. There are other tests for these purposes; this test is one of several.

What is dementia

Dementia is severe cognitive impairment, also called dementia. You can often hear about dementia and what it is in general from relatives of people with dementia, because they themselves are not critical of changes in their abilities, and sometimes are not able to evaluate them.

People with dementia commit rash actions that have little connection with social ideas. Here's an example: senile dementia. Left at home unattended by other people, it can be easy to forget to light a gas burner that is on or forget about a lit one, clean your shoes with a toothbrush, wipe the floor with a curtain, and other eccentricities.

Therefore, it is often possible to clarify the picture of the disease after a conversation with the patient’s relatives and friends, who, with a cry from the heart, talk about how their loved one began to behave, “painting” a picture of dementia in all colors. Of course, for close people, the change of a loved one is a tragedy.

Dementia leads to personality changes, up to a distant removal from normal life and once loved ones.

Treatment of cognitive impairment, and, in particular, dementia, is an important and at the same time complex task. Read about this further in the article.

Symptoms

At the stage of moderate and severe cognitive impairment, it is quite difficult to correct them and achieve significant results by prescribing appropriate treatment. An elderly man lives with his relatives in an apartment; he can’t find something, he forgets the names of his relatives or friends, he didn’t close the refrigerator door... - a situation that is familiar to many and is unlikely to cause surprise to the average person. However, this is already a wake-up call.

Most often, impairments in cognitive functions appear noticeably and more clearly when they have already become moderate or severe, or are even manifestations of “double” dementia.

Of course, such features of the lives of, say, elderly or senile people in our society seem to be quite commonplace. But I’ll tell you that not everyone experiences things like this at 70, 80, and sometimes at 90.

Of course, heredity plays a big role, besides, age-related changes and signs of aging are one thing, and signs of a serious disease such as Alzheimer's disease are another. We will not dwell in more detail on the features and differences in these situations; diagnosis and establishment of a diagnosis is a medical matter. Here we describe the signs that may occur with the above-described changes:

• decreased memory for current events
• dyscalculia
• failure to state the current date, month and year or incorrect indication
• inability to name simple surrounding objects (for example: pen, book, chair, etc.)
• disorientation in the environment and time
• failure to recognize loved ones

If these symptoms recur in your loved ones and relatives with enviable regularity or have occurred more than once, do not delay; here you need a consultation with a neurologist, and sometimes you may need the help of a psychiatrist in prescribing and correcting treatment. Treatment of cognitive impairment and dementia, in particular, deserves its own discussion topic.

An example of a diagnosis accompanied by cognitive impairment: CCI (chronic cerebral circulatory failure) grade 3 with severe cognitive impairment

We will dwell on the topic of treating dementia and discuss it in more detail in new articles - stay tuned. If you have any questions or comments about the article, leave them below in the appropriate column.

Published by author

Many people know that poor 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 decline 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 manifest themselves, are diagnosed and treated: we will look at them in our review and video in this article.

The brain has become less able to cope with its work - perhaps this is a sign of illness

The essence of the problem

Cognitive refers to the most complex brain functions associated with:

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

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

Pay attention! Each person has his own level of development of cognitive abilities, determined by genetic characteristics. So, some can boast of a phenomenal memory, while others have difficulty memorizing simple quatrains. 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 include:

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

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

What disorders are more common in CVD?

So, what cognitive impairments are caused by impaired cerebral vascular tone? Depending on the severity, they are divided into light, moderate and severe.

Mild degree

A mild degree of impairment is characterized by maintaining the 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 express anxiety about this.

Pay attention! Deterioration of short-term memory and absent-mindedness are among the first symptoms of chronic cerebrovascular diseases, which are accompanied by impaired cerebral vascular tone.

Despite the patients' complaints of mild cognitive impairment:

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

Moderate degree

Moderate disorders are accompanied by 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 cognitive dysfunction:

• are reflected in the patient’s complaints;
• noticeable to others;
• interfere with the performance of complex intellectual tasks.

Pay attention! According to statistics, this form of pathology is detected in 12-17% of the world's elderly population.

Severe degree

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

Dementia is an acquired mental disorder, which 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 received information;
• attention;
• speech;
• gnosis– the ability to recognize objects by perception using the senses;
• praxis– ability to perform purposeful movements;
• thinking;
• ability to plan;
• ability to make decisions;
• ability to control own work and the actions of others.

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

It manifests itself as a slowdown and rigidity of all mental processes. Patients experience difficulties even when performing simple household tasks (shopping for groceries, preparing meals). Mnestic disorders are primarily expressed in a decrease in learning ability, and later there is a memory impairment for past and current events.

More than 50% of patients experience emotional “incontinence” - weakness, tearfulness, and 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:

Syndrome (localization of lesion - see photo)	Manifestations
	decreased strength in the lower extremities; inability to make “fine” movements - threading a needle, playing musical instruments; development of spastic gait (limitation of leg movement); increased knee tendon reflex; the appearance of pathological reflexes (Babinsky, Oppenheimer, Rossolimo).
	dysarthria – pronunciation problems; dysphonia – loss of voice sonority; dysphagia is a disorder of swallowing.
	intention tremor (shaking) of the fingers; "drunk" gait; inability to perform a series of rapid, repetitive movements (for example, dialing a telephone number); nystagmus; changes in handwriting, which becomes large and clumsy.

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

Methods for diagnosing cognitive impairment

Diagnosis of cognitive disorders is carried out by a neurologist.

Standard instructions imply the use of the following minimum scope of examination:

1. Collection of complaints and medical history (according to 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;
• Brief Mental Status Rating Scale.

Principles of treatment

The main role in the correction of cognitive disorders in CVD is given 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 concentrations in the blood is of no small importance.

If cognitive impairment occurs after an acute cerebral stroke, the following 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 crossword puzzles.

Additionally, medications may be prescribed:

• Piracetam;
• Galantamine;
• Donepizil;
• Vinpocetine;
• Gliatilin and others.

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 medications.

With rare exceptions, cognitive impairment is a problem in old age. To avoid decline in 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 conduct “training” for the brain.

Good results in the prevention of cognitive decline are also achieved by timely treatment of circulatory disorders in the cerebral vessels.