ABSTRACT. Over 44 million people suffer from dementia around the world. Researchers estimated that there will be 48.1 million people with dementia by 2020 and 90.3 million by 2040. In addition to dementia, mild cognitive impairment (MCI) and subjective cognitive decline (SCD) relate to cognitive impairment. It has been established that MCI precedes dementia, however the significance of SCD is still unclear. Recent studies suggest that SCD could be a risk factor for objective cognitive impairment. SCD is defined as а self-estimated decline in cognitive capacity in comparison to an individual’s previous level of functioning, which cannot be determined by neuropsychological tests. Objectives: To perform a systematic review of prospective longitudinal cohort studies that assessed the risk of MCI and dementia among people with SCD. Methods: A search was carried out for all available peer-reviewed articles in English related to SCD in PubMed and PsychINFO databases from database initiation through January 2020. The keywords used for the search were ‘subjective cognitive (or memory) impairment (or decline or complaints)’. Three authors separately determined the inclusion or exclusion of all articles retrieved for full-text evaluation. Results: The chance of progression to dementia in the SCD group was 2.17 (95% confidence interval [95%CI] 1.53‒3.07; p<0.05) compared to normal aging. Furthermore, the SCD group was 2.15 times more likely to progress to MCI than the group without SCD (95%CI 1.39‒3.30; p=0.005). Conclusions: SCD might precede cognitive impairment, however, more detailed longitudinal studies should be conducted.

(headache, dizziness, etc.).

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Cognitive disorders (CDs)

5560 patients with the diagnosis “Other cerebral vascular diseases” per 100 000 of elderly population were registered in RF in 2017. Usually this is a code for chronic brain ischemia (CBI) – the most popular diagnosis in Russian neurological practice. However, diagnostic criteria of CBI are not well defined and need to be ascertained. Recent studies show that the most reliable clinical feature of CBI could be cognitive impairment. It is developed before other clinical signs and correlate with severity of vascular brain lesions. Typically, cognitive impairment is subcortical with prominent bradyphrenia, attentional, dysexecutive and visuospatial deficit and relative sparing of memory. However clinical diagnosis of CBI could be only hypothetical. Diagnosis should be verified by MRI or other visualization technic. Diagnosis is verified if neuroimaging revealed silent strokes, microbleeds and vascular leukoencephalopathy. The most important objective of chronic brain ischemia management is the control of basic vascular disease. Besides this, pathogenetic therapy should be performed to improve cerebral microcirculation, neuronal metabolism and to provide neuroprotection. There is positive data on dipyridamole usage in chronic brain ischemia. It has desagregative, vasotropic, antioxidative and antiinflammation properties. Dypiridamole treatment in CBI patients lead to decrease of neuropsychiatric symptoms and improvement of well-being.

The paper presents the proceedings of the Round Table with the participation of leading neurologists, which is devoted to chronic cerebrovascular diseases. It is noted that chronic cerebral ischemia (CCI), or dyscirculatory encephalopathy (DEP), is one of the most common neurological diagnoses in our country. The pathogenesis, clinical presentations, diagnosis and treatment of CCI (DEP) and its matching with vascular cognitive impairment (CI), which is regarded in foreign literature as the main manifestation of chronic cerebrovascular disease (CVD) were considered. The authors analyze clinical trials evaluating the efficacy of vinpocetine (Cavinton) in chronic CVD, dizziness, CI, as well as the use of new vinpocetine formulations, such as Cavinton Comforte, in various neurological diseases, dysphagia in particular, in poststroke patients.

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