ABSTRACT
Polyneuropathy in patients with diabetes mellitus is manifested by a lesion of peripheral sensory, motor and autonomic nervous system. Different severity of damage of sensory, motor and autonomic fibers in typical and atypical forms of diabetic polyneuropathy, requires a differentiated approach to therapy, but not the rejection of its implementation. In an interdisciplinary consensus, consultations are held with physicians from different regions of the Russian Federation, and modern methods of diagnosing and assessing the severity of diabetic polyneuropathies, which determine the algorithm for treating patients, are discussed.
Subject(s)
Diabetic Neuropathies , Polyneuropathies , Diabetic Neuropathies/diagnosis , Humans , Polyneuropathies/diagnosis , Russia , Severity of Illness IndexABSTRACT
AIM: The objective of the present study was to evaluate the effectiveness of dosed physical exercises for the combined treatment of the patients presenting with mild to moderate dementia associated with Alzheimer's disease (AD). MATERIAL AND METHODS: The comprehensive examination involved 41 patients (32 women and 9 men) with the confirmed diagnosis of 'probable' AD with stages 1 and 2 of dementia and 17 healthy volunteers comprising the group of comparison. In all the patients, the neurological examination was supplemented by neuropsychological testing. Two treatment modalities were applied, one being conventional therapy with the use of memantine at the average effective dose, the other with the combination of memantine and dosed physical exercises including elements of cognitive training. RESULTS: In the group of patients treated with memantine alone, changes in cognitive performances among the men did not suggest any statistically significant positive trendency whereas the results of estimation in the women based on the clock drawing test (CDT) and the Mini-Mental State Examination (MMSE) scores revealed the significant improvement of cognitive performances. The most pronounced effects were documented in the women who had received combined therapy with the inclusion of dosed physical exercises in the form of walking. The comparison of the results of the treatment with observations of the patients included in the comparison group demonstrated the improvement of frontal cognitive functioning in the patients of both sexes under the influence of the combined treatment which manifested itself as the absence of the statistically significant differences between the results of the evaluation based on the Frontal Assessment Battery (FAB) scale. CONCLUSION: The prescription of dosed physical exercises with elements of cognitive training to be applied for the treatment of the patients presenting with dementia of different severity associated with Alzheimer's disease makes it possible to optimize the outcome of the conventional medical treatment and thereby to improve the results of scoring assessments of cognitive performances based on the MMSE, FAB, and CDT scales.
Subject(s)
Alzheimer Disease/physiopathology , Alzheimer Disease/therapy , Cognitive Behavioral Therapy/methods , Exercise Therapy/methods , Memantine/administration & dosage , Walking , Aged , Female , Humans , MaleABSTRACT
The dosed walking efficacy with including the cognitive training as the component of complex therapy of mild and moderate dementia was examined in elderly patients with the probable Alzheimer's disease and mixed dementia. It was stated that dosed walking with cognitive training interventions improved cognitive performance in patients with probable Alzheimer's disease to a greater extent as compared to a single medical therapy and patients with mixed dementia probably due to severe structural changes of the brain. Female patients showed more advantageous health outcome.
Subject(s)
Cognitive Dysfunction/rehabilitation , Dementia/rehabilitation , Walking , Aged , Alzheimer Disease/rehabilitation , Brain/pathology , Female , Humans , MaleABSTRACT
The differences in level of soluble forms of receptor for advanced glycation end-products (sRAGE) in the blood serum of patients with Alzheimer's disease and mixed vascular-degenerative cognitive impairment were studied. sRAGE in blood serum of the patients with Alzheimer's disease is lower than that in patients with mixed vascular-degenerative cognitive impairments. Correlation analysis of serum sRAGE level and indicators of cognitive status was performed. Low level of sRAGE is associated with worse memory that is typical for Alzheimer's neurodegenerative process. This fact confirms the pathogenetic significance of the studied biomarker.
Subject(s)
Alzheimer Disease , Cognition , Cognitive Dysfunction , Biomarkers , Glycation End Products, Advanced , Humans , Receptor for Advanced Glycation End ProductsABSTRACT
OBJECTIVES: To study the degenerative and regenerative age-related changes in human hippocampus. MATERIALS AND METHODS: An immunohistochemical investigation of the hippocampus was carried out in 50 people, aged 25-89 years, who died for different reasons not connected with the cerebral injury or pathology. Expression of the following markers was determined: tau-protein, GFAP, CD105/endoglin, E-selectin, NCAM, Cdk2. Statistical analysis was performed with the program package Biostat. RESULTS AND CONCLUSIONS: Gliogenesis and vasculogenesis processes were active in old and very old age. They may be conditioned by ischemic cerebral injuries and accompany the development of Alzheimer's disease.
