medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/2079-701X-2019-18-52-58medsovet-4926Research ArticleКОГНИТИВНЫЕ РАССТРОЙСТВАCOGNITIVE DISRODERSCовременный взгляд на возможности профилактики деменцииA contemporary view of the possibilities of preventing dementiahttps://orcid.org/0000-0002-6327-3546БоголеповаА. Н.BogolepovaA. N.

Боголепова Анна Николаевна, д.м.н., профессор кафедры неврологии, нейрохирургии и медицинской генетики

117997, Москва, ул. Островитянова, д. 1

Anna N. Bogolepova, Dr. of Sci. (Med.), Professor of Chair for Neurology, Neurosurgery and Medical Genetics

1 Ostrovityanova St., Moscow, 117997

annabogolepova@yandex.ruРоссийский национальный исследовательский медицинский университет им. Н.И. ПироговаРоссияFederal State Budgetary Educational Institution of Higher Education «Pirogov Russian National Research Medical University» of the Ministry of Health of the Russian FederationRussian Federation2019301120190185258Copyright © Боголепова А.Н., 20192019Боголепова А.Н.Bogolepova A.N.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/4926

Распространенность деменции прогрессивно увеличивается, что делает актуальной проблему профилактики. Первичная профилактика деменции заключается в предотвращении трансформации умеренных когнитивных расстройств (УКР) в деменцию, вторичная профилактика – это раннее выявление и раннее лечение деменции, а третичная профилактика – это снижение темпов прогрессирования деменции.

В современных исследованиях большое внимание уделяется коррекции модифицируемых факторов риска, обусловленных образом жизни, как первичной профилактики.

Очень важным компонентом здорового образа жизни, направленного на предотвращение развития когнитивного снижения, является физическая активность. Механизмы положительного влияния физической активности на когнитивные функции связаны с уменьшением риска сердечно-сосудистых заболеваний, повышением церебральной перфузии и мозгового кровотока, изменением нейрогенеза и нейрональной пластичности. Стратегии, связанные с питанием, сосредоточены на формировании диеты, среди которых наиболее многообещающие результаты показала средиземноморская диета. Нормализация сна также считается очень важным аспектом профилактики когнитивных расстройств, т. к. нарушения сна провоцируют развитие сердечнососудистой патологии, приводят к изменению обмена амилоида.

Однако, наряду с борьбой с факторами риска, сейчас все большее внимание уделяется возможностям медикаментозной профилактики развития деменции. Проведенные экспериментальные исследования подтверждают нейропротективный эффект Акатинола (мемантин). В клинических исследованиях доказана эффективность Акатинола в терапии болезни Альцгеймера и сосудистой деменции и продемонстрирован болезнь-модифицирующий эффект.

The prevalence of dementia increases progressively, which actualizes the issue of prevention. Primary prevention of dementia involves preventing the transformation of mild cognitive impairment (MCI) into dementia, secondary prevention involves the early detection and early treatment of dementia, and tertiary prevention involves slowing down the progression of dementia. Current studies pay much attention to the correction of modifiable risk factors due to lifestyle, as primary prevention. Physical activity is a very important component of a healthy lifestyle, which is aimed at preventing the development of cognitive decline. The mechanisms of the positive effect of physical activity on cognitive functions are associated with decreased risk of cardiovascular disease, increased cerebral perfusion and cerebral blood flow, changes in neurogenesis and neuronal plasticity. Nutrition strategies focus on dieting, among which the Mediterranean diet has produced hopeful results. Sleep normalization is also considered a very important aspect of the prevention of cognitive impairment, because sleep disturbances provoke the development of cardiovascular pathology and affect the amyloid metabolism. However, along with combating risk factors, more and more attention is now being paid to the possibilities of drug treatments to prevent dementia. The experimental studies confirmed the neuroprotective effect of Akatinol (memantine). The clinical studies proved the efficacy of Akatinol in the treatment of Alzheimer’s disease and vascular dementia and showed the disease-modifying effect.

когнитивные нарушенияпрофилактикасонфизическая активностьдиетамемантинАкатинолcognitive impairmentpreventionsleepphysical activitydietmemantineAkatinolReferencesДеменция. Информационный бюллетень ВОЗ. Май 2019 г. Режим доступа: https:// www.who.int/ru/news-room/facts-in-pictures/ detail/dementia. Dementia WHO Newsletter. May 2019 (In Russ.) Available at: https://www.who.int/ru/ news-room/facts-in-pictures/detail/dementia.Деменция. Информационный бюллетень ВОЗ. Май 2019 г. Режим доступа: https:// www.who.int/ru/news-room/facts-in-pictures/ detail/dementia. Dementia WHO Newsletter. May 2019 (In Russ.) Available at: https://www.who.int/ru/ news-room/facts-in-pictures/detail/dementia.Garre-Olmo J. Epidemiology of Alzheimer’s disease and other dementias. Rev Neurol. 2018;66(11):377-386. Available at: https:// www.ncbi.nlm.nih.gov/pubmed/29790571.Garre-Olmo J. Epidemiology of Alzheimer’s disease and other dementias. Rev Neurol. 2018;66(11):377-386. Available at: https:// www.ncbi.nlm.nih.gov/pubmed/29790571.Urakami K. Prevention of dementia. Nihon Rinsho. 2016;74(3):395-398. Available at: https://www.researchgate.net/publication/306137606_Prevention_of_dementia.Urakami K. Prevention of dementia. Nihon Rinsho. 2016;74(3):395-398. Available at: https://www.researchgate.net/publication/306137606_Prevention_of_dementia.Деменция. Информационный бюллетень ВОЗ. Декабрь 2017 г. Режим доступа: http:// медулица.рф/news/voz/demenciya.-informacionnyy-byulleten-dekabr-2017. Dementia WHO Newsletter. December 2017 (In Russ.) Available at: http://медулица.рф/ news/voz/demenciya.-informacionnyy-byulleten-dekabr-2017 .Деменция. Информационный бюллетень ВОЗ. Декабрь 2017 г. Режим доступа: http:// медулица.рф/news/voz/demenciya.-informacionnyy-byulleten-dekabr-2017. Dementia WHO Newsletter. December 2017 (In Russ.) Available at: http://медулица.рф/ news/voz/demenciya.-informacionnyy-byulleten-dekabr-2017 .Livingston G., Sommerlad A., Orgeta V., Costafreda S.G., Huntley J., Ames D. et al. Dementia prevention, intervention, and care. Lancet. 2017;390(10113):2673-2734. 10.1016/ S0140-6736(17)31363-6.Livingston G., Sommerlad A., Orgeta V., Costafreda S.G., Huntley J., Ames D. et al. Dementia prevention, intervention, and care. Lancet. 2017;390(10113):2673-2734. 10.1016/ S0140-6736(17)31363-6.Neergaard J.S., Dragsbæk K., Hansen H.B., Henriksen K., Christiansen C., Karsdal M.A. Late-life risk factors for all-cause dementia and differential dementia diagnoses in women: a prospective cohort study. Medicine (Baltimore). 2016;95(11):e3112. doi: 10.1097/ MD.0000000000003112.Neergaard J.S., Dragsbæk K., Hansen H.B., Henriksen K., Christiansen C., Karsdal M.A. Late-life risk factors for all-cause dementia and differential dementia diagnoses in women: a prospective cohort study. Medicine (Baltimore). 2016;95(11):e3112. doi: 10.1097/ MD.0000000000003112.Llamas-Velasco S., Contador I., VillarejoGalende A., Lora-Pablos D., Bermejo-Pareja F. Physical activity as protective factor against dementia: a prospective population-based study (NEDICES). J Int Neuropsychol Soc. 2015;21(10):861-7. doi: 10.1017/ S1355617715000831.Llamas-Velasco S., Contador I., VillarejoGalende A., Lora-Pablos D., Bermejo-Pareja F. Physical activity as protective factor against dementia: a prospective population-based study (NEDICES). J Int Neuropsychol Soc. 2015;21(10):861-7. doi: 10.1017/ S1355617715000831.Tolppanen A.M., Solomon A., Kulmala J., Kåreholt I., Ngandu T., Rusanen M., Laatikainen T., Soininen H., Kivipelto M. Leisure-time physical activity from mid- to late life, body mass index, and risk of dementia. Alzheimers Dement. 2015;11(4):434-443.e6. doi: 10.1016/j.jalz.2014.01.008.Tolppanen A.M., Solomon A., Kulmala J., Kåreholt I., Ngandu T., Rusanen M., Laatikainen T., Soininen H., Kivipelto M. Leisure-time physical activity from mid- to late life, body mass index, and risk of dementia. Alzheimers Dement. 2015;11(4):434-443.e6. doi: 10.1016/j.jalz.2014.01.008.Scarmeas N., Luchsinger J.A., Schupf N., Brickman A.M., Cosentino S., Tang M.X., Stern Y. Physical activity, diet, and risk of Alzheimer disease. JAMA. 2009;302(6):627-637. doi: 10.1001/jama.2009.1144.Scarmeas N., Luchsinger J.A., Schupf N., Brickman A.M., Cosentino S., Tang M.X., Stern Y. Physical activity, diet, and risk of Alzheimer disease. JAMA. 2009;302(6):627-637. doi: 10.1001/jama.2009.1144.Vancampfort D., Stubbs B., Lara E., Vandenbulcke M., Swinnen N., Koyanagi A. Mild cognitive impairment and physical activity in the general population: Findings from six low- and middle-income countries. Exp Gerontol. 2017;(100):100-105. doi: 10.1016/j. exger.2017.10.028.Vancampfort D., Stubbs B., Lara E., Vandenbulcke M., Swinnen N., Koyanagi A. Mild cognitive impairment and physical activity in the general population: Findings from six low- and middle-income countries. Exp Gerontol. 2017;(100):100-105. doi: 10.1016/j. exger.2017.10.028.de Bruijn R.F., Schrijvers E.M., de Groot K.A., Witteman J.C., Hofman A., Franco O.H., Koudstaal P.J., Ikram M.A. The association between physical activity and dementia in an elderly population: the Rotterdam Study. Eur J Epidemiol. 2013;28(3):277-283. doi: 10.1007/ s10654-013-9773-3.de Bruijn R.F., Schrijvers E.M., de Groot K.A., Witteman J.C., Hofman A., Franco O.H., Koudstaal P.J., Ikram M.A. The association between physical activity and dementia in an elderly population: the Rotterdam Study. Eur J Epidemiol. 2013;28(3):277-283. doi: 10.1007/ s10654-013-9773-3.Iso-Markku P., Waller K., Kujala U.M., Kaprio J. Physical activity and dementia: long-term follow-up study of adult twins. Ann Med. 2015;47(2):81-87. doi: 10.3109/07853890.2014.994675.Iso-Markku P., Waller K., Kujala U.M., Kaprio J. Physical activity and dementia: long-term follow-up study of adult twins. Ann Med. 2015;47(2):81-87. doi: 10.3109/07853890.2014.994675.Middleton L.E., Ventura M.I., Santos-Modesitt W., Poelke G., Yaffe K., Barnes D.E. The Mental Activity and eXercise (MAX) trial: Effects on physical function and quality of life among older adults with cognitive complaints. Contemp Clin Trials. 2018;(64):161-166. doi: 10.1016/j.cct.2017.10.009.Middleton L.E., Ventura M.I., Santos-Modesitt W., Poelke G., Yaffe K., Barnes D.E. The Mental Activity and eXercise (MAX) trial: Effects on physical function and quality of life among older adults with cognitive complaints. Contemp Clin Trials. 2018;(64):161-166. doi: 10.1016/j.cct.2017.10.009.Shimada H., Makizako H., Doi T., Park H., Tsutsumimoto K., Verghese J., Suzuki T. Effects of Combined Physical and Cognitive Exercises on Cognition and Mobility in Patients With Mild Cognitive Impairment: A Randomized Clinical Trial. J Am Med Dir Assoc. 2018l;19(7):584-591. doi: 10.1016/j. jamda.2017.09.019.Shimada H., Makizako H., Doi T., Park H., Tsutsumimoto K., Verghese J., Suzuki T. Effects of Combined Physical and Cognitive Exercises on Cognition and Mobility in Patients With Mild Cognitive Impairment: A Randomized Clinical Trial. J Am Med Dir Assoc. 2018l;19(7):584-591. doi: 10.1016/j. jamda.2017.09.019.Hsu C.L., Best J.R., Davis J.C., Nagamatsu L.S., Wang S., Boyd L.A., Hsiung G.R., Voss M.W., Eng J.J., Liu-Ambrose T. Aerobic exercise promotes executive functions and impacts functional neural activity among older adults with vascular cognitive impairment. Br J Sports Med. 2018;52(3):184-191. doi: 10.1136/bjsports-2016-096846.Hsu C.L., Best J.R., Davis J.C., Nagamatsu L.S., Wang S., Boyd L.A., Hsiung G.R., Voss M.W., Eng J.J., Liu-Ambrose T. Aerobic exercise promotes executive functions and impacts functional neural activity among older adults with vascular cognitive impairment. Br J Sports Med. 2018;52(3):184-191. doi: 10.1136/bjsports-2016-096846.Liu-Ambrose T., Best J.R., Davis J.C., Eng J.J., Lee P.E., Jacova C., Boyd L.A., Brasher P.M., Munkacsy M., Cheung W., Hsiung G.R. Aerobic exercise and vascular cognitive impairment: A randomized controlled trial. Neurology. 2016;87(20):2082-2090. doi: 10.1212/ WNL.0000000000003332.Liu-Ambrose T., Best J.R., Davis J.C., Eng J.J., Lee P.E., Jacova C., Boyd L.A., Brasher P.M., Munkacsy M., Cheung W., Hsiung G.R. Aerobic exercise and vascular cognitive impairment: A randomized controlled trial. Neurology. 2016;87(20):2082-2090. doi: 10.1212/ WNL.0000000000003332.Tan Z.S., Spartano N.L., Beiser A.S., DeCarli C., Auerbach S.H., Vasan R.S., Seshadri S. Physical activity, brain volume, and dementia risk: the Framingham study. J Gerontol A Biol Sci Med Sci. 2017;72(6):789-795. doi: 10.1093/gerona/ glw130.Tan Z.S., Spartano N.L., Beiser A.S., DeCarli C., Auerbach S.H., Vasan R.S., Seshadri S. Physical activity, brain volume, and dementia risk: the Framingham study. J Gerontol A Biol Sci Med Sci. 2017;72(6):789-795. doi: 10.1093/gerona/ glw130.Erickson K.I., Voss M.W., Prakash R.S., Basak C., Szabo A., Chaddock L. et al. Exercise training increases size of hippocampus and improves memory. Proc Natl Acad Sci U S A. 2011;108(7):3017-3022. doi: 10.1073/ pnas.1015950108.Erickson K.I., Voss M.W., Prakash R.S., Basak C., Szabo A., Chaddock L. et al. Exercise training increases size of hippocampus and improves memory. Proc Natl Acad Sci U S A. 2011;108(7):3017-3022. doi: 10.1073/ pnas.1015950108.Varma V.R., Chuang Y.F., Harris G.C., Tan E.J., Carlson M.C. Low-intensity daily walking activity is associated with hippocampal volume in older adults. Hippocampus. 2015 May;25(5):605-15. doi: 10.1002/hipo.22397.Varma V.R., Chuang Y.F., Harris G.C., Tan E.J., Carlson M.C. Low-intensity daily walking activity is associated with hippocampal volume in older adults. Hippocampus. 2015 May;25(5):605-15. doi: 10.1002/hipo.22397.Baumgart M., Snyder H.M., Carrillo M.C., Fazio S., Kim H., Johns H. Summary of the evidence on modifiable risk factors for cognitive decline and dementia: a population-based perspective. Alzheimers Dement. 2015;11(6):718-726. doi: 10.1016/j.jalz.2015.05.016.Baumgart M., Snyder H.M., Carrillo M.C., Fazio S., Kim H., Johns H. Summary of the evidence on modifiable risk factors for cognitive decline and dementia: a population-based perspective. Alzheimers Dement. 2015;11(6):718-726. doi: 10.1016/j.jalz.2015.05.016.Gallaway P.J., Miyake H., Buchowski M.S., Shimada M., Yoshitake Y., Kim A.S., Hongu N. Physical Activity: A Viable Way to Reduce the Risks of Mild Cognitive Impairment, Alzheimer’s Disease, and Vascular Dementia in Older Adults. Brain Sci. 2017;7(2):E22. doi: 10.3390/brainsci7020022.Gallaway P.J., Miyake H., Buchowski M.S., Shimada M., Yoshitake Y., Kim A.S., Hongu N. Physical Activity: A Viable Way to Reduce the Risks of Mild Cognitive Impairment, Alzheimer’s Disease, and Vascular Dementia in Older Adults. Brain Sci. 2017;7(2):E22. doi: 10.3390/brainsci7020022.Swain R.A., Harris A.B., Wiener E.C., Dutka M.V., Morris H.D., Theien B.E., Konda S., Engberg K., Lauterbur P.C., Greenough W.T. Prolonged exercise induces angiogenesis and increases cerebral blood volume in primary motor cortex of the rat. Neuroscience. 2003;(117):1037– 1046 doi: 10.1016/s0306-4522(02)00664-4.Swain R.A., Harris A.B., Wiener E.C., Dutka M.V., Morris H.D., Theien B.E., Konda S., Engberg K., Lauterbur P.C., Greenough W.T. Prolonged exercise induces angiogenesis and increases cerebral blood volume in primary motor cortex of the rat. Neuroscience. 2003;(117):1037– 1046 doi: 10.1016/s0306-4522(02)00664-4.Leeuwis A.E., Hooghiemstra A.M., Amier R., Ferro D.A., Franken L., Nijveldt R. et al. Heart Brain Connection study group. Design of the ExCersion-VCI study: The effect of aerobic exercise on cerebral perfusion in patients with vascular cognitive impairment. Alzheimers Dement (N Y). 2017;3(2):157-165. doi: 10.1016/j.trci.2017.02.002.Leeuwis A.E., Hooghiemstra A.M., Amier R., Ferro D.A., Franken L., Nijveldt R. et al. Heart Brain Connection study group. Design of the ExCersion-VCI study: The effect of aerobic exercise on cerebral perfusion in patients with vascular cognitive impairment. Alzheimers Dement (N Y). 2017;3(2):157-165. doi: 10.1016/j.trci.2017.02.002.Trigiani L.J., Hamel E. An endothelial link between the benefits of physical exercise in dementia. J Cereb Blood Flow Metab. 2017;37(8):2649-2664. doi: 10.1177/0271678X17714655.Trigiani L.J., Hamel E. An endothelial link between the benefits of physical exercise in dementia. J Cereb Blood Flow Metab. 2017;37(8):2649-2664. doi: 10.1177/0271678X17714655.Shen Y., Li R. What do we know from clinical trials on exercise and Alzheimer’s disease? J Sport Health Sci. 2016;5(4):397-399. doi: 10.1016/j.jshs.2016.10.002.Shen Y., Li R. What do we know from clinical trials on exercise and Alzheimer’s disease? J Sport Health Sci. 2016;5(4):397-399. doi: 10.1016/j.jshs.2016.10.002.Honea R.A., Thomas G.P., Harsha A., Anderson H.S., Donnelly J.E., Brooks W.M., Burns J.M. Cardiorespiratory fitness and preserved medial temporal lobe volume in Alzheimer’s disease. Alzheimer Dis Assoc Disord. 2009;(23):188–197. doi: 10.1097/ WAD.0b013e31819cb8a2.Honea R.A., Thomas G.P., Harsha A., Anderson H.S., Donnelly J.E., Brooks W.M., Burns J.M. Cardiorespiratory fitness and preserved medial temporal lobe volume in Alzheimer’s disease. Alzheimer Dis Assoc Disord. 2009;(23):188–197. doi: 10.1097/ WAD.0b013e31819cb8a2.Erickson K.I., Voss M.W., Prakash R.S., Basak C., Szabo A., Chaddock L. et al. Exercise training increases size of hippocampus and improves memory. Proc Natl Acad Sci U S A. 2011;(108):3017–3022. doi: 10.1073/ pnas.1015950108.Erickson K.I., Voss M.W., Prakash R.S., Basak C., Szabo A., Chaddock L. et al. Exercise training increases size of hippocampus and improves memory. Proc Natl Acad Sci U S A. 2011;(108):3017–3022. doi: 10.1073/ pnas.1015950108.Seifert T., Brassard P., Wissenberg M., Rasmussen P., Nordby P., Stallknecht B. et al. Endurance training enhances BDNF release from the human brain. Am J Physiol Regul Integr Comp Physiol. 2010;298(2):R372-377. doi: 10.1152/ajpregu.00525.2009.Seifert T., Brassard P., Wissenberg M., Rasmussen P., Nordby P., Stallknecht B. et al. Endurance training enhances BDNF release from the human brain. Am J Physiol Regul Integr Comp Physiol. 2010;298(2):R372-377. doi: 10.1152/ajpregu.00525.2009.Ströhle A., Stoy M., Graetz B., Scheel M., Wittmann A., Gallinat J., Lang U.E., Dimeo F., Hellweg R. Acute exercise ameliorates reduced brain-derived neurotrophic factor in patients with panic disorder. Psychoneuroendocrinology. 2010;35(3):364-368. doi: 10.1016/j.psyneuen.2009.07.013.Ströhle A., Stoy M., Graetz B., Scheel M., Wittmann A., Gallinat J., Lang U.E., Dimeo F., Hellweg R. Acute exercise ameliorates reduced brain-derived neurotrophic factor in patients with panic disorder. Psychoneuroendocrinology. 2010;35(3):364-368. doi: 10.1016/j.psyneuen.2009.07.013.Bink D.I., Ritz K., Aronica E., van der Weerd L., Daemen M.J. Mouse models to study the effect of cardiovascular risk factors on brain structure and cognition. J Cereb Blood Flow Metab. 2013;(33):1666–1684. doi: 10.1038/ jcbfm.2013.140.Bink D.I., Ritz K., Aronica E., van der Weerd L., Daemen M.J. Mouse models to study the effect of cardiovascular risk factors on brain structure and cognition. J Cereb Blood Flow Metab. 2013;(33):1666–1684. doi: 10.1038/ jcbfm.2013.140.Sallis J.F., Bull F., Guthold R., Heath G.W., Inoue S., Kelly P., Oyeyemi A.L., Perez L.G., Richards J., Hallal P.C. Lancet Physical Activity Series 2 Executive Committee. Progress in physical activity over the Olympic quadrennium. Lancet. 2016;388(10051):1325-1336. doi: 10.1016/ S0140-6736(16)30581-5.Sallis J.F., Bull F., Guthold R., Heath G.W., Inoue S., Kelly P., Oyeyemi A.L., Perez L.G., Richards J., Hallal P.C. Lancet Physical Activity Series 2 Executive Committee. Progress in physical activity over the Olympic quadrennium. Lancet. 2016;388(10051):1325-1336. doi: 10.1016/ S0140-6736(16)30581-5.Greenwood C.E., Parrott M.D. Nutrition as a component of dementia risk reduction strategies. Healthc Manage Forum. 2017;30(1):40-45. doi: 10.1177/0840470416662885.Greenwood C.E., Parrott M.D. Nutrition as a component of dementia risk reduction strategies. Healthc Manage Forum. 2017;30(1):40-45. doi: 10.1177/0840470416662885.Voortman T., Kiefte-de Jong J.C., Ikram M.A., Stricker B.H., van Rooij F.J.A., Lahousse L., Tiemeier H., Brusselle G.G., Franco O.H., Schoufour J.D. Adherence to the 2015 Dutch dietary guidelines and risk of non-communicable diseases and mortality in the Rotterdam Study. Eur J Epidemiol. 2017;32(11):993-1005. doi: 10.1007/s10654-017-0295-2.Voortman T., Kiefte-de Jong J.C., Ikram M.A., Stricker B.H., van Rooij F.J.A., Lahousse L., Tiemeier H., Brusselle G.G., Franco O.H., Schoufour J.D. Adherence to the 2015 Dutch dietary guidelines and risk of non-communicable diseases and mortality in the Rotterdam Study. Eur J Epidemiol. 2017;32(11):993-1005. doi: 10.1007/s10654-017-0295-2.Morris M.C., Tangney C.C. Dietary fat composition and dementia risk. Neurobiol Aging. 2014;35(2):59-64. doi: 10.1016/j.neurobiolaging.2014.03.038.Morris M.C., Tangney C.C. Dietary fat composition and dementia risk. Neurobiol Aging. 2014;35(2):59-64. doi: 10.1016/j.neurobiolaging.2014.03.038.Zeng L.F., Cao Y., Liang W.X., Bao W.H., Pan J.K., Wang Q. et al. An exploration of the role of a fish-oriented diet in cognitive decline: a systematic review of the literature. Oncotarget. 2017;8(24):39877-39895. doi: 10.18632/oncotarget.16347.Zeng L.F., Cao Y., Liang W.X., Bao W.H., Pan J.K., Wang Q. et al. An exploration of the role of a fish-oriented diet in cognitive decline: a systematic review of the literature. Oncotarget. 2017;8(24):39877-39895. doi: 10.18632/oncotarget.16347.Cao L., Tan L., Wang H.F., Jiang T., Zhu X.C., Lu H., Tan M.S., Yu J.T. Dietary Patterns and Risk of Dementia: a Systematic Review and MetaAnalysis of Cohort Studies. Mol Neurobiol. 2016;53(9):6144-6154. doi: 10.1007/s12035015-9516-4.Cao L., Tan L., Wang H.F., Jiang T., Zhu X.C., Lu H., Tan M.S., Yu J.T. Dietary Patterns and Risk of Dementia: a Systematic Review and MetaAnalysis of Cohort Studies. Mol Neurobiol. 2016;53(9):6144-6154. doi: 10.1007/s12035015-9516-4.Bloomfield H., Kane R., Koeller E., Greer N., MacDonald R., Wilt T.J. Benefits and Harms of the Mediterranean Diet Compared to Other Diets. Washington (DC): Department of Veterans Affairs (US); 2015.Bloomfield H., Kane R., Koeller E., Greer N., MacDonald R., Wilt T.J. Benefits and Harms of the Mediterranean Diet Compared to Other Diets. Washington (DC): Department of Veterans Affairs (US); 2015.Aridi Y.S., Walker J.L., Wright O.R.L. The Association between the Mediterranean Dietary Pattern and Cognitive Health: A Systematic Review. Nutrients. 2017;(9):674. doi: 10.3390/nu9070674.Aridi Y.S., Walker J.L., Wright O.R.L. The Association between the Mediterranean Dietary Pattern and Cognitive Health: A Systematic Review. Nutrients. 2017;(9):674. doi: 10.3390/nu9070674.Safouris A., Tsivgoulis G., Sergentanis T.N., Psaltopoulou T. Mediterranean Diet and Risk of Dementia. Curr Alzheimer Res. 2015;12(8):736-744. Available at: https://www. ncbi.nlm.nih.gov/pubmed/26159192.Safouris A., Tsivgoulis G., Sergentanis T.N., Psaltopoulou T. Mediterranean Diet and Risk of Dementia. Curr Alzheimer Res. 2015;12(8):736-744. Available at: https://www. ncbi.nlm.nih.gov/pubmed/26159192.Hernando-Requejo V. Nutrition and cognitive impairment. Nutr Hosp. 2016;33(4):346. doi: 10.20960/nh.346.Hernando-Requejo V. Nutrition and cognitive impairment. Nutr Hosp. 2016;33(4):346. doi: 10.20960/nh.346.Solfrizzi V., Custodero C., Lozupone M., Imbimbo B.P., Valiani V., Agosti P. et al. Relationships of Dietary Patterns, Foods, and Micro- and Macronutrients with Alzheimer’s Disease and Late-Life Cognitive Disorders: A Systematic Review. J Alzheimers Dis. 2017;59(3):815-849. doi: 10.3233/JAD-170248.Solfrizzi V., Custodero C., Lozupone M., Imbimbo B.P., Valiani V., Agosti P. et al. Relationships of Dietary Patterns, Foods, and Micro- and Macronutrients with Alzheimer’s Disease and Late-Life Cognitive Disorders: A Systematic Review. J Alzheimers Dis. 2017;59(3):815-849. doi: 10.3233/JAD-170248.Petersson S.D., Philippou E. Mediterranean Diet, Cognitive Function, and Dementia: A Systematic Review of the Evidence. Adv Nutr. 2016;7(5):889-904. doi: 10.3945/ an.116.012138.Petersson S.D., Philippou E. Mediterranean Diet, Cognitive Function, and Dementia: A Systematic Review of the Evidence. Adv Nutr. 2016;7(5):889-904. doi: 10.3945/ an.116.012138.Miranda A., Gómez-Gaete C., Mennickent S. Role of Mediterranean diet on the prevention of Alzheimer disease. Rev Med Chil. 2017;145(4):501-507. doi: 10.4067/S003498872017000400010.Miranda A., Gómez-Gaete C., Mennickent S. Role of Mediterranean diet on the prevention of Alzheimer disease. Rev Med Chil. 2017;145(4):501-507. doi: 10.4067/S003498872017000400010.Phillips C. Lifestyle Modulators of Neuroplasticity: How Physical Activity, Mental Engagement, and Diet Promote Cognitive Health during Aging. Neural Plast. 2017:3589271. doi: 10.1155/2017/3589271.Phillips C. Lifestyle Modulators of Neuroplasticity: How Physical Activity, Mental Engagement, and Diet Promote Cognitive Health during Aging. Neural Plast. 2017:3589271. doi: 10.1155/2017/3589271.Born J., Wilhelm I. System consolidation of memory during sleep. Psychol Res. 2012;76(2):192-203. doi: 10.1007/s00426011-0335-6.Born J., Wilhelm I. System consolidation of memory during sleep. Psychol Res. 2012;76(2):192-203. doi: 10.1007/s00426011-0335-6.Benedict C., Byberg L., Cedernaes J., Hogenkamp P.S., Giedratis V., Kilander L., Lind L., Lannfelt L., Schiöth H.B. Self-reported sleep disturbance is associated with Alzheimer’s disease risk in men. Alzheimers Dement. 2015;11(9):1090-1097. doi: 10.1016/j. jalz.2014.08.104.Benedict C., Byberg L., Cedernaes J., Hogenkamp P.S., Giedratis V., Kilander L., Lind L., Lannfelt L., Schiöth H.B. Self-reported sleep disturbance is associated with Alzheimer’s disease risk in men. Alzheimers Dement. 2015;11(9):1090-1097. doi: 10.1016/j. jalz.2014.08.104.Hoevenaar-Blom M., Spijkerman A., Kromhout D. Sleep duration and sleep quality in relation to 12-year cardiovascular disease incidence : the MORGEN-study. Sleep. 2011;34(11):14871492. doi: 10.5665/sleep.1382.Hoevenaar-Blom M., Spijkerman A., Kromhout D. Sleep duration and sleep quality in relation to 12-year cardiovascular disease incidence : the MORGEN-study. Sleep. 2011;34(11):14871492. doi: 10.5665/sleep.1382.Magee C., Kritharides L., Attia J. Short and long sleep duration are associated with prevalent cardiovascular disease in Australian adults. J Sleep Res. 2012;21(4):441-447. doi: 10.1111/j.1365-2869.2011.00993.x.Magee C., Kritharides L., Attia J. Short and long sleep duration are associated with prevalent cardiovascular disease in Australian adults. J Sleep Res. 2012;21(4):441-447. doi: 10.1111/j.1365-2869.2011.00993.x.Kim H.B., Myung S.K., Lee S.M., Park Y.C. Korean Meta-Analysis (KORMA) Study Group. Longer Duration of Sleep and Risk of Cognitive Decline: A Meta-Analysis of Observational Studies. Neuroepidemiology. 2016;47(3-4):171-180. doi: 10.1159/000454737.Kim H.B., Myung S.K., Lee S.M., Park Y.C. Korean Meta-Analysis (KORMA) Study Group. Longer Duration of Sleep and Risk of Cognitive Decline: A Meta-Analysis of Observational Studies. Neuroepidemiology. 2016;47(3-4):171-180. doi: 10.1159/000454737.Pase M.P., Himali J.J., Grima N.A., Beiser A.S., Satizabal C.L., Aparicio H.J., Thomas R.J., Gottlieb D.J., Auerbach S.H., Seshadri S. Sleep architecture and the risk of incident dementia in the community. Neurology. 2017;89(12):12441250. doi: 10.1212/WNL.0000000000004373.Pase M.P., Himali J.J., Grima N.A., Beiser A.S., Satizabal C.L., Aparicio H.J., Thomas R.J., Gottlieb D.J., Auerbach S.H., Seshadri S. Sleep architecture and the risk of incident dementia in the community. Neurology. 2017;89(12):12441250. doi: 10.1212/WNL.0000000000004373.Боголепова А.Н. Нарушения сна и болезнь Альцгеймера. Неврология, нейропсихиатрия, психосоматика. 2018;10(1):74–77. doi: 10.14412/2074-2711-2018-1-74-77 . Bogolepova A.N. Sleep disorders and Alzheimer’s disease. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, neuropsychiatry, psychosomatics. 2018;10(1):74–77. (In Russ.) doi: 10.14412/2074-2711-2018-1-74-77 .Боголепова А.Н. Нарушения сна и болезнь Альцгеймера. Неврология, нейропсихиатрия, психосоматика. 2018;10(1):74–77. doi: 10.14412/2074-2711-2018-1-74-77 . Bogolepova A.N. Sleep disorders and Alzheimer’s disease. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, neuropsychiatry, psychosomatics. 2018;10(1):74–77. (In Russ.) doi: 10.14412/2074-2711-2018-1-74-77 .Shi L., Chen S.J., Ma M.Y., Bao Y.P., Han Y., Wang Y.M., Shi J., Vitiello M.V., Lu L. Sleep disturbance increase the risk of dementia: A systematic review and meta-analysis. Sleep Med Rev. 2018;(40):4-16. doi: 10.1016/j. smrv.2017.06.010.Shi L., Chen S.J., Ma M.Y., Bao Y.P., Han Y., Wang Y.M., Shi J., Vitiello M.V., Lu L. Sleep disturbance increase the risk of dementia: A systematic review and meta-analysis. Sleep Med Rev. 2018;(40):4-16. doi: 10.1016/j. smrv.2017.06.010.Bubu O.M., Brannick M., Mortimer J., Umasabor-Bubu O., Sebastião Y.V., Wen Y., et al. Sleep, Cognitive impairment, and Alzheimer’s disease: A Systematic Review and Meta-Analysis. Sleep. 2017;40(1). doi: 10.1093/ sleep/zsw032.Bubu O.M., Brannick M., Mortimer J., Umasabor-Bubu O., Sebastião Y.V., Wen Y., et al. Sleep, Cognitive impairment, and Alzheimer’s disease: A Systematic Review and Meta-Analysis. Sleep. 2017;40(1). doi: 10.1093/ sleep/zsw032.Wang R., Reddy P.H. Role of glutamate and NMDA receptors in Alzheimer’s disease. J Alzheimers Dis. 2017;57(4):1041-1048. doi: 10.3233/JAD-160763.Wang R., Reddy P.H. Role of glutamate and NMDA receptors in Alzheimer’s disease. J Alzheimers Dis. 2017;57(4):1041-1048. doi: 10.3233/JAD-160763.Ito K., Tatebe T., Suzuki K., Hirayama T., Hayakawa M., Kubo H., Tomita T., Makino M. Memantine reduces the production of amyloid-β peptides through modulation of amyloid precursor protein trafficking. Eur J Pharmacol. 2017;(798):16-25. doi: 10.1016/j. ejphar.2017.02.001.Ito K., Tatebe T., Suzuki K., Hirayama T., Hayakawa M., Kubo H., Tomita T., Makino M. Memantine reduces the production of amyloid-β peptides through modulation of amyloid precursor protein trafficking. Eur J Pharmacol. 2017;(798):16-25. doi: 10.1016/j. ejphar.2017.02.001.Kodis E.J. N-methyl-D-aspartate receptor– mediated calcium influx connects amyloid-b oligomers to ectopic neuronal cell cycle reentry in Alzheimer’s disease. 2018. Alzheimer’s & Dementia. 2018;14(10):1302–1312 doi: 10.1016/j.jalz.2018.05.017 .Kodis E.J. N-methyl-D-aspartate receptor– mediated calcium influx connects amyloid-b oligomers to ectopic neuronal cell cycle reentry in Alzheimer’s disease. 2018. Alzheimer’s & Dementia. 2018;14(10):1302–1312 doi: 10.1016/j.jalz.2018.05.017 .Wang F., Zou Z., Gong Y., Yuan D., Chen X., Sun T. Regulation of Human Brain Microvascular Endothelial Cell Adhesion and Barrier Functions by Memantine. J Mol Neurosci. 2017;62(1):123129. doi: 10.1007/s12031-017-0917-x.Wang F., Zou Z., Gong Y., Yuan D., Chen X., Sun T. Regulation of Human Brain Microvascular Endothelial Cell Adhesion and Barrier Functions by Memantine. J Mol Neurosci. 2017;62(1):123129. doi: 10.1007/s12031-017-0917-x.Martinez-Coria H., Green K.N., Billings L.M., Kitazawa M., Albrecht M., Rammes G. et al. Memantine improves cognition and reduces Alzheimer’s-like neuropathology in transgenic mice. Am J Pathol. 2010;176(2):870-880. doi: 10.2353/ajpath.2010.090452.Martinez-Coria H., Green K.N., Billings L.M., Kitazawa M., Albrecht M., Rammes G. et al. Memantine improves cognition and reduces Alzheimer’s-like neuropathology in transgenic mice. Am J Pathol. 2010;176(2):870-880. doi: 10.2353/ajpath.2010.090452.Ilhan Algin D., Dagli Atalay S., Ozkan S., Ozbabalik Adapinar D., Ak Sivrioz I. Memantine improves semantic memory in patients with amnestic mild cognitive impairment: A singlephoton emission computed to`mography study. J Int Med Res. 2017;45(6):2053-2064. doi: 10.1177/0300060517715166.Ilhan Algin D., Dagli Atalay S., Ozkan S., Ozbabalik Adapinar D., Ak Sivrioz I. Memantine improves semantic memory in patients with amnestic mild cognitive impairment: A singlephoton emission computed to`mography study. J Int Med Res. 2017;45(6):2053-2064. doi: 10.1177/0300060517715166.Liang J., Li J., Jia R., Wang Y., Wu R., Zhang H., Xu Y. Identification of the optimal cognitive drugs among Alzheimer’s disease: a Bayesian meta-analytic review. Clinical Interventions in Aging. 2018;13:2061–2073. doi: 10.2147/CIA. S184968.Liang J., Li J., Jia R., Wang Y., Wu R., Zhang H., Xu Y. Identification of the optimal cognitive drugs among Alzheimer’s disease: a Bayesian meta-analytic review. Clinical Interventions in Aging. 2018;13:2061–2073. doi: 10.2147/CIA. S184968.Jin B.R., Liu H.Y. Comparative efficacy and safety of cognitive enhancers for treating vascular cognitive impairment: systematic review and Bayesian network meta-analysis. Neural Regen Res. 2019;14(5):805-816. doi: 10.4103/1673-5374.249228.Jin B.R., Liu H.Y. Comparative efficacy and safety of cognitive enhancers for treating vascular cognitive impairment: systematic review and Bayesian network meta-analysis. Neural Regen Res. 2019;14(5):805-816. doi: 10.4103/1673-5374.249228.

The authors declare that there are no conflicts of interest present.