Abstract—This review provides information about the features of cognitive dysfunctions that occur in various diseases and conditions, and data on the history of the creation and characteristic features of nootropics. The review presents the mechanisms of action and the spectrum of pharmacological effects of nootropic drugs from various groups: drugs that affect brain metabolism, neurotransmitter systems (cholinergic, glutamatergic, GABAergic, and others), cerebral vasodilators, neuropeptides and their analogues, antioxidants, membrane protectors, and others. The free radical and mitochondrial concepts of aging and the possibility of using nootropics for the correction of cognitive impairments arising from aging, dementia, and other neurodegenerative diseases are considered.