How to preserve cognitive and mental health in case of cerebral circulatory insufficiency

In conditions of increasing life expectancy, its quality is important, regardless of age. Due to the progressive growth of the aging population, the prevention of cognitive decline has become particularly relevant. Presumably moderate cognitive impairment occurs among people aged 60 years and older in 10–36.7% of cases. With age, involutive brain processes occur, which, in combination with microangiopathy, leads to the development of chronic cerebral ischemia (CCI). The core of this pathology is a cognitive disorder in combination with mental, non-cognitive (emotional-affective, behavioral, psychotic) neuropsychiatric manifestations. It is important to maintain cognitive and mental health, and this can be achieved by influencing potentially modifiable risk factors for dementia. Thus, in the report of the permanent commission on dementia prevention, intervention and patient care of the Lancet magazine, in 2024, 14 modifiable risk factors for dementia were identified, the share of which amounted to 45% of all factors: low level of education, hearing loss, hypertension, obesity, tobacco smoking, depression, physical inactivity, social isolation, diabetes mellitus, high LDL cholesterol, alcohol abuse, traumatic brain injury, air pollution and vision loss. To influence them, it is necessary to increase physical activity, cognitive stimulation, normalization of sleep, compliance with dietary recommendations, correction of vision and hearing, control of blood pressure, etc. It is equally important to follow the doctorеs prescriptions for taking the necessary lipid-lowering, antihypertensive, antiplatelet therapy, depending on the concomitant pathology, as well as neurotrophic, vasoactive, antioxidant drugs. 2 clinical cases are given as an illustration. The drugs of choice for the correction of cognitive and neuropsychological disorders should be highly effective drugs with a good safety profile. Combined medicines have advantages due to the synergism of the action of its components, increasing the patient’s adherence to treatment, and eliminating polypragmasia.

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