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Alzheimer's disease (AD) is the most common degenerative disease of the brain leading to dementia. AD is the most common cause of disability among age-related diseases. The diagnosis of AD is based on clinical findings and is confirmed by the presence of positive biological markers of the disease, which reflect the pathological formation of beta-amyloid and tau protein in the brain. Magnetic resonance imaging of the brain shows brain atrophy in AD and helps to rule out other diseases. Psychosocial and behavioral approaches form the basis for the treatment of patients with AD; cognitive training in combination with regular physical exercise is recommended. Acetylcholinesterase inhibitors and the glutamate receptor blocker memantine are used as drugs that improve the cognitive functions of patients with AD. Dispersible forms of memantine are used to treat dysphagia in patients with AD. The efficacy and safety of pathogenetic therapy aimed at eliminating cerebral beta-amyloid by passive immunization is under discussion. Unfortunately, AD is rarely diagnosed in our country; doctors are not sufficiently informed about the diagnosis and modern treatment methods of AD. Many AD patients are observed with the misdiagnosis of chronic cerebrovascular disease and do not receive effective therapy. A clinical observation of a patient with early-onset AD is presented, reflecting typical errors in patient management. Issues for optimizing the management of AD patients are discussed.
Alzheimer's disease (AD) is the most common degenerative disease of the brain leading to dementia. AD is the most common cause of disability among age-related diseases. The diagnosis of AD is based on clinical findings and is confirmed by the presence of positive biological markers of the disease, which reflect the pathological formation of beta-amyloid and tau protein in the brain. Magnetic resonance imaging of the brain shows brain atrophy in AD and helps to rule out other diseases. Psychosocial and behavioral approaches form the basis for the treatment of patients with AD; cognitive training in combination with regular physical exercise is recommended. Acetylcholinesterase inhibitors and the glutamate receptor blocker memantine are used as drugs that improve the cognitive functions of patients with AD. Dispersible forms of memantine are used to treat dysphagia in patients with AD. The efficacy and safety of pathogenetic therapy aimed at eliminating cerebral beta-amyloid by passive immunization is under discussion. Unfortunately, AD is rarely diagnosed in our country; doctors are not sufficiently informed about the diagnosis and modern treatment methods of AD. Many AD patients are observed with the misdiagnosis of chronic cerebrovascular disease and do not receive effective therapy. A clinical observation of a patient with early-onset AD is presented, reflecting typical errors in patient management. Issues for optimizing the management of AD patients are discussed.
One of the common problems associated with aging is vitamin B12 (cobalamin) deficiency. According to some reports, it is present in every third person over the age of 60. Cobalamin is involved in numerous biologically important reactions, and its deficiency manifests itself in a range of disorders, including hematological and gastrointestinal symptoms, as well as pathology in various parts of the nervous system. The article discusses clinical variants of neurological disorders related to vitamin B12 deficiency, such as damage to both the peripheral and the central nervous systems. The relationship between cobalamin deficiency and the development of cognitive and other neuropsychiatric disorders in older individuals is discussed. Data on specific causes of vitamin B12 deficiencies in older individuals, including iatrogenic factors, are presented. Modern approaches to the diagnosis and correction of cobalamin deficiency are outlined, taking into account the characteristics of the geriatric population.
From 2019 to 2023, the global population experienced a period characterized by the outbreak of the coronavirus pandemic, which was attributed to the SARS-CoV-2 virus. Cognitive impairment, particularly memory loss, is frequently reported by individuals who have recovered from Covid-19, alongside other neurological symptoms. This phenomenon not only carries implications for individual health, but also extends to social and economic domains. This phenomenon garners the interest of scholars. Numerous empirical investigations have established a correlation between the COVID-19 pandemic and mental health disorders. The infection caused by SARS-CoV-2 has been associated with the manifestation of psychiatric symptoms. Additionally, individuals with pre-existing mental illness are more susceptible to experiencing more severe outcomes of COVID-19, increased mortality rates, and enduring residual symptoms over an extended period of time. Dementia itself encompasses a multitude of risk factors, including but not limited to advanced age, vascular and metabolic disorders, obesity, hypodynamic lifestyle, various infections, depression, smoking and social isolation. These factors should be considered collectively when evaluating cognitive impairment following COVID-19 infection. Nevertheless, it is obvious that COVID-19 survivors frequently experience health concerns related to memory, attention, perception, and other cognitive domains, necessitating thorough assessment and, in certain cases, intervention. Given the frequency of “memory decline” in the post-Covid period, especially in young and middle age, it is evident that cognitive dysfunction caused by COVID-19 impairment can have detrimental effects on both quality of life and the ability to perform daily tasks efficiently. In summary, the existing literature review indicates a lack of comprehensive understanding regarding the impact of COVID-19 on cognitive impairment. Consequently, there is a pressing need for further research endeavors that are more focused and specific in nature.
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