Mild cognitive impairment: A case study
https://doi.org/10.21518/ms2026-044
Abstract
Cognitive impairment can develop in various neurological, psychiatric, and somatic diseases and encompass a spectrum of neuropsychological changes from mild cognitive impairment to dementia. The clinical picture is determined by the underlying disease causing the cognitive impairment and its severity, manifesting as a deterioration in cognitive functions (attention, memory, speech, praxis, gnosis, and executive functions) compared to baseline. Examination of patients with cognitive impairment includes collecting complaints and anamnesis, a physical examination with neurological status, a neuropsychological examination with an assessment of cognitive functions, neuroimaging, laboratory, and instrumental diagnostic methods. The most common differential diagnoses include asthenic syndrome (chronic fatigue syndrome), anxiety and depressive disorders, fatigue syndrome after a viral illness, and chronic cerebral ischemia. To illustrate the diagnostic process, this article presents three clinical cases. The combination drug Vinpotropile has demonstrated efficacy and safety in achieving this goal. Treatment of mild cognitive impairment should be aimed at both reducing their severity and preventing the potential development of dementia. Non-pharmacological treatments play a significant role in therapy.
About the Authors
D. Kh. Khaibullina
Kazan State Medical Academy
Russian Federation
Russian Federation
Dina Kh. Khaibullina - Cand. Sci. (Med.), Associate Professor of the Department of Neurology, Kazan State Medical Academy.
36, Butlerov St., Kazan, 420012
Yu. N. Maksimov
Kazan State Medical Academy
Russian Federation
Russian Federation
Yuriy N. Maksimov - Cand. Sci. (Med.), Associate Professor of the Department of Neurology, Kazan State Medical Academy.
36, Butlerov St., Kazan, 420012
M. V. Belousova
Kazan State Medical Academy
Russian Federation
Russian Federation
Marina V. Belousova - Cand. Sci. (Med.), Associate Professor of the Department of Child Neurology named after Professor A.Yu. Ratner, Head of the Department of Psychotherapy and Narcology, Kazan State Medical Academy..
36, Butlerov St., Kazan, 420012
B. Е. Gubeev
Kazan State Medical Academy
Russian Federation
Russian Federation
Bulat Е. Gubeev - Cand. Sci. (Med.), Associate Professor of the Department of Neurology, Kazan State Medical Academy.
36, Butlerov St., Kazan, 420012
References
1. Tkacheva ON, Yakhno NN, Neznanov NG, Shport SV, Shamalov NA, Levin OS et al. Clinical guidelines “Cognitive disorders in the elderly and senile persons”. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2025;125(3-3):7–149. (In Russ.) https://doi.org/10.17116/jnevro202512533.
2. Jia L, Du Y, Chu L, Zhang Z, Li F, Lyu D et al. Prevalence, risk factors, and management of dementia and mild cognitive impairment in adults aged 60 years or older in China: a cross-sectional study. Lancet Public Health. 2020;5(12):e661–e671. https://doi.org/10.1016/S2468-2667(20)30185-7.
3. Ward A, Arrighi HM, Michels S, Cedarbaum JM. Mild cognitive impairment: disparity of incidence and prevalence estimates. Alzheimers Dement. 2012;8(1):14–21. https://doi.org/10.1016/j.jalz.2011.01.002.
4. Yakhno NN, Preobrazhenskaya IS, Zakharov VV, Stepkina DA, Lokshina AB, Mkhitaryan EA et al. Prevalence of cognitive impairments in neurological diseases: Analysis of the activities of a specialized outpatient reception office. Neurology, Neuropsychiatry, Psychosomatics. 2012;4(2):30–35. (In Russ.) https://doi.org/10.14412/2074-2711-2012-378.
5. Tkacheva ON, Mkhitaryan EA, Isaev RI, Runikhina NK, Sharashkina NV, Kotovskaya SE et al. Prevalence of cognitive impairment in elderly, senile people and centenarians. Byulleten Natsionalnogo Obshchestva po Izucheniyu Bolezni Parkinsona i Rasstroystv Dvizheniy. 2022;(2):200–202. (In Russ.) https://doi.org/10.24412/2226-079X-2022-12466.
6. Mkhitaryan EA, Vorobieva NM, Tkacheva ON, Kotovskaya YV, Koberskaya NN, Selezneva EV, Ovcharova LN. The prevalence of cognitive impairment and their association with socioeconomic, demographic and anthropometric factors and geriatric syndromes in people over 65 years of age: data from the Russian epidemiological study EVKALIPT. Neurology, Neuropsychiatry, Psychosomatics. 2022;14(3):44–53. (In Russ.) https://doi.org/10.14412/2074-2711-2022-3-44-53.
7. Isaev RI, Mkhitaryan EA, Strazhesko ID, Vorobyeva NM, Ostapenko VS, Tkacheva ON, Yakhno NN. Cognitive status in institutionalized oldest old. Russian Neurological Journal. 2022;27(6):63–69. (In Russ.) https://doi.org/10.30629/2658-7947-2022-27-6-63-69.
8. Sachdev PS, Lipnicki DM, Kochan NA, Crawford JD, Thalamuthu A, Andrews G et al. The Prevalence of Mild Cognitive Impairment in Diverse Geographical and Ethnocultural Regions: The COSMIC Collaboration. PLoS ONE. 2015;10(11):e0142388. https://doi.org/10.1371/journal.pone.0142388.
9. Bai W, Chen P, Cai H, Zhang Q, Su Z, Cheung T et al. Worldwide prevalence of mild cognitive impairment among community dwellers aged 50 years and older: a meta-analysis and systematic review of epidemiology studies. Age Ageing. 2022;51(8):afac173. https://doi.org/10.1093/ageing/afac173.
10. Gorelick PB, Scuteri A, Black SE, Decarli C, Greenberg SM, Iadecola C et al. Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42(9):2672–2713. https://doi.org/10.1161/STR.0b013e3182299496.
11. Chan KY, Wang W, Wu JJ, Liu L, Theodoratou E, Car J et al. Epidemiology of Alzheimer’s disease and other forms of dementia in China, 1990–2010: a systematic review and analysis. Lancet. 2013;381(9882):2016–2023. https://doi.org/10.1016/S0140-6736(13)60221-4.
12. Jhoo JH, Kim KW, Huh Y, Lee SB, Park JH, Lee JJ et al. Prevalence of dementia and its subtypes in an elderly urban Korean population: results from the Korean Longitudinal Study on Health and Aging (KLoSHA). Dement Geriatr Cogn Disord. 2008;26(3):270–276. https://doi.org/10.1159/000160960.
13. Brayne C, Richardson K, Matthews FE, Fleming J, Hunter S, Xuereb JH et al. Neuropathological correlates of dementia in over-80-year-old brain donors from the population-based Cambridge city over-75 s cohort (CC75C) study. J Alzheimers Dis. 2009;18(3):645–658. https://doi.org/10.3233/JAD-2009-1182.
14. Matsui Y, Tanizaki Y, Arima H, Yonemoto K, D o i Y, Ninomiya T et al. Incidence and survival of dementia in a general population of Japanese elderly: the Hisayama study. J Neurol Neurosurg Psychiatry. 2009;80(4):366–370. https://doi.org/10.1136/jnnp.2008.155481.
15. Suemoto CK, Ferretti-Rebustini RE, Rodriguez RD, Leite RE, Soterio L, Brucki SM et al. Neuropathological diagnoses and clinical correlates in older adults in Brazil: a cross-sectional study. PLoS Med. 2017;14(3):e1002267. https://doi.org/10.1371/journal.pmed.1002267.
16. Troncoso JC, Zonderman AB, Resnick SM, Crain B, Pletnikova O, O’Brien RJ. Effect of infarcts on dementia in the Baltimore longitudinal study of aging. Ann Neurol. 2008;64(2):168–176. https://doi.org/10.1002/ana.21413.
17. Azarpazhooh MR, Avan A, Cipriano LE, Munoz DG, Sposato LA, Hachinski V. Concomitant vascular and neurodegenerative pathologies double the risk of dementia. Alzheimers Dement. 2018;14(2):148–156. https://doi.org/10.1016/j.jalz.2017.07.755.
18. Schneider JA, Arvanitakis Z, Bang W, Bennett DA. Mixed brain pathologies account for most dementia cases in community-dwelling older persons. Neurology. 2007;69(24):2197–2204. https://doi.org/10.1212/01.wnl.0000271090.28148.24.
19. Kapasi A, DeCarli C, Schneider JA. Impact of multiple pathologies on the threshold for clinically overt dementia. Acta Neuropathol. 2017;134(2):171–186. https://doi.org/10.1007/s00401-017-1717-7.
20. Power MC, Mormino E, Soldan A, James BD, Yu L, Armstrong NM et al. Combined neuropathological pathways account for age-related risk of dementia. Ann Neurol. 2018;84(1):10–22. https://doi.org/10.1002/ana.25246.
21. Chang Wong E, Chang Chui H. Vascular Cognitive Impairment and Dementia. Continuum. 2022;28(3):750–780. https://doi.org/10.1212/CON.0000000000001124.
22. Levine DA, Springer MV, Brodtmann A. Blood Pressure and Vascular Cognitive Impairment. Stroke. 2022;53(4):1104–1113. https://doi.org/10.1161/STROKEAHA.121.036140.
23. Cherdak MA, Mkhitaryan EA, Sharashkina NV, Ostapenko VS, Isaev RI, Seyfedinova AB et al. Prevalence of cognitive impairment in older adults in the Russian Federation. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2024;124(4):5–11. (In Russ.) https://doi.org/10.17116/jnevro20241240425.
24. Parfenov VA, Silina EV, Danielyan AR. Diagnosis and treatment of cognitive impairment in outpatient practice. Meditsinskiy Sovet. 2025;19(13):48–54. (In Russ.) https://doi.org/10.21518/ms2025-266.
25. Parfenov VA, Silina EV. Cognitive impairment in patients with chronic cerebral ischemia (discirculatory encephalopathy). Neurology, Neuropsychiatry, Psychosomatics. 2025;17(3):120–126. (In Russ.) https://doi.org/10.14412/20742711-2025-3-120-126.
26. Kamchatnov PR, Mityaeva EV, Chugunov AV, Evzelman MA. Small cerebral artery disease. Behavioral Neurology. 2021;(1):52–58. (In Russ.) https://doi.org/10.46393/2712-9675_2021_1_52-58.
27. Esin RG, Gorobets EA, Sharafeev EF, Mashtakova AI. Cerebral small vessel disease and multiple sclerosis: Similarities and differences. Meditsinskiy Sovet. 2025;19(12):22–29. (In Russ.) https://doi.org/10.21518/ms2025-222.
28. Khabirov FA, Rakhmatullina EF, Kochergina OS, Khaibullina DKh. Diagnosis and therapy of cognitive impairment in chronic cerebral ischemia. Meditsinskiy Sovet. 2025;19(3):71–80. (In Russ.) https://doi.org/10.21518/ms2025-102.
29. Esin RG, Gorobets EA, Esin OR, Mashtakova AI. Chronic traumatic encephalopathy. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2025;125(8):16–24. (In Russ.) https://doi.org/10.17116/jnevro202512508116.
30. Kovalchuk VV, Barantsevich ER, Drozdova MS, Nesterin KV. Cognitive failure as a Manifestation of Various Neurodegenerative and Angioneurological Diseases. Effective Pharmacotherapy. 2023;19(54):46–54. (In Russ.) https://doi.org/10.33978/2307-3586-2023-19-54-46-54.
31. Woods B, Arosio F, Diaz A, Gove D, Holmerová I, Kinnaird L et al. Timely diagnosis of dementia? Family carers’ experiences in 5 European countries. Int J Geriatr Psychiatry. 2019;34(1):114–121. https://doi.org/10.1002/gps.4997.
32. Dubois B, Hampel H, Feldman HH, Scheltens P, Aisen P, Andrieu S et al. Preclinical Alzheimer’s disease: Definition, natural history, and diagnostic criteria. Alzheimers Dement. 2016;12(3):292–323. https://doi.org/10.1016/j.jalz.2016.02.002.
33. Kotova OV, Akarachkova ES. Asthenic syndrome in neurological and family doctor practice. RMJ. 2016;(13):824–829. (In Russ.) Available at: https://www.rmj.ru/articles/nevrologiya/Astenicheskiy_sindrom_v_praktike_nevrologa_i_semeynogo_vracha.
34. Khaibullina DKh, Maksimov YN. Asthenic post-COVID syndrome. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2023;123(3):61–69. (In Russ.) https://doi.org/10.17116/jnevro202312303161.
35. Young P, Finn BC, Bruetman J, Pellegrini D, Kremer A. The chronic asthenia syndrome: a clinical approach. Medicina. 2010;70(3):284–292. Available at: https://pubmed.ncbi.nlm.nih.gov/20529781.
36. Stormorken E, Jason LA, Kirkevold M. From good health to illness with post-infectious fatigue syndrome: a qualitative study of adults’ experiences of the illness trajectory. BMC Fam Pract. 2017;18(1):49–52. https://doi.org/10.1186/s12875-017-0614-4.
37. Wessely S, Chalder T, Hirsch S, Wallace P, Wright D. The prevalence and morbidity of chronic fatigue and chronic fatigue syndrome: a prospective primary care study. Am J Public Health. 1997;87(9):1449–1455. https://doi.org/10.2105/ajph.87.9.1449.
38. Zakharov VV, Lokshina AB, Stakhovskaya LV, Timerbaeva SL, Lagoda OV. Vinpotropil in the treatment of dyscirculatory encephalopathy with cognitive impairment without dementia. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2007;107(9):76–78. (In Russ.) Available at: https://medi.ru/info/2210/.
39. Filimonov VA, Klyeva VN, Kondrashova IN. Vinpotropile in therapy of vascular diseases of the brain. Psychopharmacology and Biological Narcology. 2005;5(1):827–831. (In Russ.) Available at: https://elibrary.ru/hspbrv.
40. Ivanova NE, Panuntsev VS. The use of vinpotropile in chronic brain ishemia. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2008;108(1):73–75. (In Russ.) Available at: https://elibrary.ru/ijrupf.
41. Yakhno NN, Zakharov VV. Vinpotropil in the treatment of dyscirculatory encephalopathy with cognitive impairment without dementia. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova. 2010;110(11):13–16. (In Russ.) Available at: https://medi.ru/info/2210.
42. Kamchatnov PR, Evzelman MA, Morozova YuA. Possibilities of combination therapy for patients with chronic cerebrovascular disorders. Poliklinika. 2017;2(2):73–78. (In Russ.) Available at: https://poliklin.ru/article2017_2(2)_73.php.
43. Zhang J, Wei R, Chen Z, Luo B. Piracetam for Aphasia in Post-stroke Patients: A Systematic Review and Meta-analysis of Randomized Controlled Trials. CNS Drugs. 2016;30(7):575–587. https://doi.org/10.1007/s40263-016-0348-1.
44. Kotova O.V., Akarachkova E.S. Vascular cognitive impairment. The role of the original combination of Vinpocetropil in their correction. Poliklinika. 2017;(3):17–20. (In Russ.) Available at: https://poliklin.ru/article2017_1(1)_17.php.
45. Khabarov IYu, Tarantsova MS, Raev VK. Modern pharmacotherapy of asthenic disorders in concomitant trauma. Russian Military Medical Academy Reports. 2020;39(S3-4):278–285. (In Russ.) Available at: https://elibrary.ru/ftnthb.
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For citations:
Khaibullina DK, Maksimov YN, Belousova MV, Gubeev BЕ. Mild cognitive impairment: A case study. Meditsinskiy sovet = Medical Council. 2026;(3):65-74. (In Russ.) https://doi.org/10.21518/ms2026-044
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