[Dynamics of cognitive functions using the rehabilitation program of cognitive training]. / Dinamika kognitivnykh funktsii pri ispol'zovanii reabilitatsionnoi programmy kognitivnogo treninga.

OBJECTIVE: To study the efficiency of the neuropsychological rehabilitation of patients with mild cognitive impairments. MATERIAL AND METHODS: The study included 103 elderly people, aged 59 to 88 years, including 90 women and 13 men with subjective complaints of memory loss (ICD-10: F06.70; F06.71; F06.78; F06.79). Participants were divided into experimental group (n=43) and comparison group (n=42). The estimated impact was the rehabilitation program «The psychosocial therapy and neurocognitive rehabilitation of elderly patients with cognitive impairments¼, within which the principle of complex stimulation of various parameters of the cognitive sphere was used in rehabilitation work with patients in the experimental group in accordance with the «Memory Clinic¼ program. The study was conducted using randomized, equalized comparison groups, and the principle of «triple-blind¼ research. Non-parametric statistics (SPSS) methods were used to assess differences. RESULTS: A significant difference between the comparison and experimental groups has been identified, primarily in relation to high-level mental processes associated with the function of the third structural-functional block according to A.R. Luria. After the training, the number of correct answers significantly increased (t(42)=-2.67, p<0.001) in the experimental group, while in the comparison group the indicator did not change (t(41)=0.50, p=0.617). The number of false alarms in the experimental group decreased significantly (t(42)=2.13, p=0.039). CONCLUSION: The results confirm the leading role of these processes in the hierarchy of mental functions, which suggests that they should primarily be targets of rehabilitation interventions.

[Use of modern classification systems for complex diagnostics of Alzheimer's disease]. / Primenenie sovremennykh klassifikatsionnykh sistem dlya kompleksnoi diagnostiki bolezni Al'tsgeimera.

OBJECTIVE: To compare the content of ß-amyloid (Aß) peptides Aß40, Aß42, total and threonine phosphorylated 181 tau-protein in cerebrospinal fluid (CSF) of patients with the clinical diagnosis of Alzheimer's disease (AD). MATERIAL AND METHODS: The study was performed on 64 patients with a diagnosis of dementia and MMSE scores of 24 or lower. All patients underwent lumbar puncture. Aß40, Aß42, Aß42/40 ratio, total tau, phosphorylated tau at threonine 181 were determined in the CSF using a multiplex assay according to the manufacturer's protocol, the concentration was determined in pkg/ml. RESULTS: The preliminary diagnosis of AD was made in 3 patients (5%). As a result of the study of protein content in the CSF, signs of AD were detected in 48 (75%) people. The findings suggest that the diagnosis of AD is made 10-14 times less frequently than it should be according to the World Health Organization data. The discrepancy between clinical diagnosis and laboratory findings is confirmed by our study. CONCLUSION: Differences in the therapy of dementias and the development of new drugs targeting specific links in the pathogenesis of different types of dementias require accurate and complete diagnosis of dementias, especially AD, as the most common type of dementia.

[Dynamics of cognitive functions in elderly and old people after completing a comprehensive neurocognitive rehabilitation program]. / Dinamika kognitivnykh funktsii u lits pozhilogo i starcheskogo vozrasta po okonchanii kompleksnoi programmy neirokognitivnoi reabilitatsii.

OBJECTIVE: To analyze the differences in the dynamics of cognitive functions in the elderly and old people during a comprehensive neurocognitive rehabilitation program with- and without drug therapy. MATERIAL AND METHODS: Ninety-six patients, aged 53-88 years, with cognitive impairment of varying degrees are divided into two groups depending on the presence/absence of drug therapy during the neurocognitive rehabilitation program. Assessment of cognitive functions was carried out twice: at the beginning and at the end of the rehabilitation program using international cognitive status assessment scales (MMSE and MoCA). RESULTS: The analysis of the dynamics of cognitive functions revealed the high efficiency of the neurocognitive rehabilitation program in both groups. The results of the study demonstrate insignificant differences in the dynamics of cognitive functions in the two groups, however, a clear direct effect of drug therapy on changes in cognitive functions has not been established. An analysis of the statistical significance of the data did not reveal differences. CONCLUSIONS: The study confirmed the positive dynamics of cognitive functions in the elderly and old people who underwent the neurocognitive rehabilitation program both with the use of drug therapy and without its use. The issue of the need to use drugs in the framework of this program requires further study. The results of the study can be used in planning programs of psychological, medical and social support for the elderly and old people.

[Neuropsychiatric symptoms in patients with mild cognitive impairment]. / Neiropsikhiatricheskie simptomy u patsientov s myagkim kognitivnym snizheniem.

OBJECTIVE: To study the prevalence of neuropsychiatric symptoms (NPS) in patients with mild cognitive impairment (MCI) who asked for help in memory clinics. MATERIAL AND METHODS: We analysed data on 729 patients with MCI (average age 76.6 years, average MMSE score 25.3), who underwent a course of cognitive neurorehabilitation in a specialized department - a memory clinic. A Russian version of Neuropsychiatric Inventory (NPI) was used. We compared the indicators for the main psychometric scales for the diagnosis of MCI in comparison with the dynamics of NPS. RESULTS: The prevalence rates for NPS differed in part from those reported in the literature. The most common symptom was anxiety (54.7%) and irritability (56.5%), while euphoria, as well as delusions and hallucinations were not detected. All disorders significantly reduced at the end of the rehabilitation program. CONCLUSION: MCI influences the level of functioning and social interaction in older patients and mediates the quality of life. Thus, given the increase in life expectancy, it is necessary to introduce new methods of examination applicable in the practice of psychiatrists to diagnose and rehabilitate such patients. NPS turned out to be widespread in MCI, but may reduce during the course of complex neurorehabilitation.

[The use of long acting antipsychotics in outpatient care]. / Analiz opyta primeneniya antipsikhotikov prolongirovannogo deistviya v ambulatornoi sluzhbe.

OBJECTIVE: To determine the frequency of administration, efficacy and safety of long acting antipsychotics in day-to-day psychiatric practice in outpatient clinics. MATERIAL AND METHODS: The study included 90 patients with schizophrenia treated with haloperidol decanoate (n=18), rispolept consta (n=19), clopixol depot (n=25), paliperidone palmitate (n=25). Symptoms of schizophrenia were assessed with PANSS during 12 months. RESULTS AND CONCLUSION: The use of long acting antipsychotics has proven to be effective and safe to control all symptom clusters in patients regardless of the disease duration.

[Complex Program of Neurocognitive Rehabilitation for Elderly Patients Suffering from Mild Cognitive Impairment Syndrome in Medical Rehabilitation Department «Memory Clinic¼].

The article introduces a complex program of neurocognitive rehabilitation into the system of dementia prevention in patients with mild cognitive impairment syndrome. It took about a year to prepare and form a complex program of neurocognitive rehabilitation (the Program). The researchers have also developed clear algorithms of the specialized medical rehabilitation unit Memory Clinic. The conducted study has proved the effectiveness of cognitive functions improvement in patients with mild cognitive impairment after participation in the Program in Memory Clinic. The authors, Professor Kostyuk, and Research Institute for Healthcare Organization and Medical Management have prepared Medical Rehabilitation Guidelines for Elderly Patients with Early Signs of Cognitive Deficits (Structural and Functional Model). The guidelines serve as a tool for practice distribution and transforming them into a project Memory Clinic.