[Russian experience in using a combination of fixed doses of donepezil and memantine in the treatment of Alzheimer's disease as an observational non-interventional multicenter program]. / Rossiiskii opyt primeneniya kombinatsii fiksirovannykh doz donepezila i memantina v terapii bolezni Al'tsgeimera v ramkakh nablyudatel'noi neinterventsionnoi mnogotsentrovoi programmy.

OBJECTIVE: To evaluate the efficacy, safety, and compliance to therapy with Mioreol, first used as part of routine clinical practice in patients with moderate-to-severe dementia due to AD. MATERIAL AND METHODS: The study was conducted as a non-interventional observational program. The work was performed on a group of 48 patients with moderate-to-severe AD aged from 60 to 90 years (median age 74 [69; 77]). The therapeutic dose of Mioreol was 10 mg donepezil + 20 mg memantine, the drug was taken orally, once a day at the same time, regardless of meals. The duration of the course of therapy was 24 weeks. The effects of the drug were assessed using the MMSE, ADAS-Cog, NPI, and CGI scales before the start of therapy and by the end of 12 and 24 weeks of treatment. RESULTS: The use of Mioreol in six-month therapy of AD patients with moderate-to-severe dementia improved not only cognitive but also a wide range of non-cognitive mental disorders. There was an improvement in the CGI-C scale in more than 50% of included patients, positive dynamics on the ADAS-cog scale (6.5 points reduction in total score) and reduction of non-cognitive mental disorders on the NPI scale (4 points reduction in total score). CONCLUSION: Fixed-dose combination therapy with Mioreol is an effective and well-tolerated treatment option for patients with moderate-to-severe AD. A combination of fixed-dose therapeutic doses of donepezil and memantine is potentially more appropriate than the simultaneous use of two recommended drugs for the treatment of AD, which will improve treatment adherence in patients with moderate to severe AD.

[Cerebrolysin Treatment Reduces the Risk of Mild Cognitive Decline to Dementia in 1st-Degree Relatives of Alzheimer's Patients: A Prospective Comparative Study]. / Lechenie Tserebrolizinom snizhaet risk perekhoda sindroma myagkogo kognitivnogo snizheniya v dementsiyu u rodstvennikov 1-i stepeni rodstva patsientov s bolezn'yu Al'tsgeimera: prospektivnoe sravnitel'noe issledovanie.

OBJECTIVE: To evaluate the long-term effects of annual course therapy with Cerebrolysin on cognitive functioning and the risk of transition to dementia in relatives of patients with Alzheimer's disease (AD) with amnestic-type mild cognitive decline syndrome (aMCI) in comparison with the same group untreated relatives. MATERIAL AND METHODS: The cohort included 88 first-degree relatives of BA patients with aMCI syndrome aged 50 to 82 years (mean age 65.0±9.9 years) of which 46 people received course therapy with Cerebrolysin and 42 people were not treated. Clinical, neuropsychological, statistical methods were used. Conducted annual course therapy with Cerebrolysin (a total of 3 courses of infusion therapy: for a course of 20 intravenous infusions of 20 ml of Cerebrolysin in 100 ml of isotonic saline) followed by a follow-up study after 3 months after the end of the therapeutic period. The dynamics of cognitive functioning in the therapeutic group was compared with the corresponding dynamics in the comparison group over the same period. The assessment was carried out on day 0, by the end of 1, 14, 27 and 30 months research. RESULTS: In the therapeutic group, according to the CGI-I scale, by the end of the 3rd course of therapy, in 95.7% of cases, a pronounced or moderate improvement was achieved after each of the courses on all scales and tests. In this group, by the end of the therapeutic period, a significant improvement in the initial mean group scores was established. According to the all scales and tests, a significant improvement of the initial average group scores was found after each course of therapy (p<0.05). In the comparison group there was a significant deterioration (p<0.05) of the average group scores of most of the cognitive scales and test by the end of the observation. The annual conversion from aMCI to dementia due to probable AD was 9.5% only in the comparison group. The average group indicators of all scales and tests significantly worsened starting from the 14th month of observation in the comparison group. CONCLUSION: The absence of cases of aMCI conversion to dementia in the treated patients for 2.5 years of observation can serve as confirmation of a disease-modifying effect in Cerebrolysin. These results indicate the need for more extensive clinical studies of the preventive effects of Cerebrolysin and to explore the possibility of including such therapy in drug prevention programs for AD in people at high risk for this disease.

[Citicoline in the treatment of cognitive impairment in first-degree relatives of AD patients: the influence of the ApoE genotype]. / Tsitikolin v lechenii kognitivnoi nedostatochnosti u rodstvennikov 1-i stepeni rodstva patsientov s bolezn'yu Al'tsgeimera: vliyanie ApoE genotipa.

OBJECTIVE: To study the effects of a three-month course of therapy with citicoline, aimed at preventing the progression of cognitive deficit in 1st-degree relatives of patients with Alzheimer's disease (AD), depending on the carriage of the ApoE4(+) genotype. MATERIAL AND METHODS: Study participants: 82 blood relatives of AD patients, 66 of them with signs of minimal cognitive dysfunction (group 1) objectively confirmed by clinical neuropsychological examination and 16 people with mild cognitive decline syndrome (group 2). Open comparative multidisciplinary study of the dynamics of cognitive status in relatives of AD patients who received a three-month course of citicoline therapy. The baseline indicators of the cognitive functioning of the relatives of the two groups were compared with the indicators at the end of the three-month course of therapy with citicoline in a daily dose of 1000 mg, depending on whether the treated persons had genotypes ApoE4(+) or ApoE4(-). Clinical-psychopathological, neuropsychological, psychometric, molecular-genetic, statistical. RESULTS: An association of the ApoE4(-) genotype with a significantly more pronounced positive effect of the course therapy with citicoline was established according to the general clinical impression (CGI-I scale), indicators of cognitive functioning (MMSE and MoCA scales), as well as according to most psychometric tests (with the exception of the number repetition test in reverse order), as well as for almost all indicators of the neuropsychological «express method¼ (excluding the parameter of the volume of visual memory). CONCLUSION: The results of course therapy with citicoline showed a negative effect of the carriage of the ε4 allele of the ApoE gene on the efficiency of treatment of blood relatives of AD patients who had signs of cognitive decline before the start of therapy, which did not reach the level of dementia. The obtained data can serve as the basis for the development of preventive therapeutic measures aimed at preventing the progression of cognitive deficit and the development of dementia in the group at high risk of developing dementia - in 1st degree relatives of AD patients, especially in carriers of the ApoE4(+) genotype.

[Left ventricular global function index as a predictor of adverse cardiovascular events in patients with acute coronary syndrome].

Aim      To evaluate the prognostic significance of the left ventricular global function index (LV GFI) in patients with acute coronary syndrome (ACS) using echocardiography (EchoCG).Material and methods             The LV GFI is an index that integrates LV cavity volumes, stroke volume, and myocardial volume. This study included 2169 patients with ACS (1340 (61.8%) men) aged 64.1±12.6 years from two observational multicenter studies, ORACLE I and ORACLE II. 1800 (83 %) cases were associated with increased concentrations of myocardial injury markers, including 826 (38.1 %) cases of ST segment elevation myocardial infarction (MI). The observation was started on the 10th day of clinical condition stabilization and lasted for one year. EchoCG was performed with evaluation of LV GFI, which was calculated as a ratio of LV stroke volume to LV global volume. The LV global volume was calculated as a sum of mean LV cavity volume (LV end-diastolic volume + LV end-systolic volume / 2) and LV myocardial volume.Results The main outcome of the study was all-cause death (n=193); recurrent coronary complications (n=253) were analyzed separately. The only EchoCG parameter indicating an adverse outcome during the one-year follow-up was a LV GFI decrease to below 22.6 % with a sensitivity of 72 % and a specificity of 60% (area under the curve, AUC=0.63). A LV GFI <22.6 % was an independent predictor of all-cause death (p=0.019) along with age (p=0.0001), history of MI (p=0.034), and presence of heart failure (HF) (p=0.044), diabetes mellitus (p=0.012), and peripheral atherosclerosis (p=0.001). The LV GFI <22.6 %, (p=0.044), heart rate upon discharge from the hospital (p=0.050), history of MI (p=0.006), presence of HF (p=0.014), and peripheral atherosclerosis (p=0.001) were also independent predictors for recurrent coronary complications. Decreased LV GFI was associated with the risk of fatal outcomes independent of the LV ejection fraction at baseline.Conclusion      In patients with ACS, the left ventricular global function index is an independent predictor for all-cause death and recurrent coronary complications and may be used for risk stratification.

[Distracter inhibition in mild cognitive impairment]. / Osobennosti podavleniya otvlekayushchikh stimulov pri myagkom kognitivnom snizhenii.

OBJECTIVE: To study the effectiveness of interfering visual stimuli inhibition using the flanker task in a group of healthy young and healthy old participants, and in a group of participants with mild cognitive impairment (MCI). MATERIAL AND METHODS: Reaction times and accuracy, as well as the diffusion model of reaction times with parameters reflecting perceptual and motor processes, stimulus processing speed, and conservativeness of response selection were analyzed. RESULTS: We found reduced speed and accuracy in older age, especially in MCI patients. The reduction was especially pronounced in patients with the incongruent distracters. For diffusion model parameters, perceptual and motor processes took longer with older age, reduced processing speed was found only in pathological aging, and specific effectiveness reduction for incongruent probes in patients was driven by increased conservativeness of responses. CONCLUSIONS: The results indicate the joint influence of normal and pathological aging processes on patients with MCI. The deceleration of the perceptual-motor components of the reaction time reflects the processes of normal cognitive aging, while the deceleration of the processing speed (in the presence of any distractors, including congruent ones) characterizes pathological cognitive aging. Differential diagnosis of normal and pathological cognitive changes is possible using data based on the analysis of reaction time components. It is important to take into account the conservativeness of responses as a factor slowing down the reaction time in pathological and normal cognitive aging.

[Delayed effects of cerebrolysin in the prevention of cognitive impairment progression in the first degree relatives of patients with Alzheimer's disease: the role of the ApoE genotype]. / Prolongirovannye effekty tserebrolizina v profilaktike progressirovaniya kognitivnogo defitsita u rodstvennikov 1 stepeni rodstva patsientov s bolezn'yu Al'tsgeimera: rol' ApoE genotipa.

OBJECTIVE: To assess the delayed effect of course therapy with cerebrolysin on the cognitive functioning of the first degree relatives of patients with Alzheimer's disease (AD), including, depending on the ApoE4 genotype. MATERIAL AND METHODS: A cohort of 72 blood relatives of patients with AD, including 46 with objectively confirmed clinical and neuropsychological examination signs of mild cognitive dysfunction (group 1) and 26 (group 2) with cognitive impairment that meets the diagnostic criteria of mild cognitive impairment (ICD-10 F06.7), was studied. The dynamics of the initial (0 day) indicators of cognitive functioning was compared immediately after a four-week course of treatment with cerebrolysin infusions, as well as 1 and 2 months after its completion, depending on the presence of ApoE4(+) or ApoE4(-) genotype. Clinical, psychopathological, psychometric, follow-up, molecular-genetic and statistical methods were used. RESULTS: A positive prolonged effect of course therapy with cerebrolysin on cognitive functioning of the first degree relatives of patients with AD was established in both groups. A significant negative effect of the ApoE4(+) genotype on the immediate and delayed effects of cerebrolysin treatment has been proven. CONCLUSION: The results can form the basis for the development of therapeutic measures aimed at preventing the progression of cognitive impairment and the development of dementia in the first degree relatives of patients with AD as those with the highest risk of dementia.

[Features of the conflict adaptation effect in mild cognitive decline.]

Conflict adaptation effect in interference control tasks (like Stroop task or flanker task) consists in better interference suppression in incongruent trials following an incongruent trial. In a flanker task is shown that in normal cognitive aging there is a null conflict adaptation effect and that in mild cognitive impairment there is a reversed (negative) conflict adaptation effect. Using the drift diffusion model of reaction time, it is shown that the change in conflict adaptation effect in mild cognitive impairment is associated with the absence of adaptive increase in processing speed in the presence of distractors. This can be interpreted as the rigidity of perceptual control mechanisms, which are responsible for strategic distribution of attention in older age and in pathological aging, in particular. The conclusion is drawn that reversed conflict adaptation effect may be an early marker of pathological cognitive aging.

[Prevention of progression of cognitive decline in the first-degree relatives of patients with Alzheimer's disease]. / Profilaktika progressirovaniia kognitivnoi nedostatochnosti u rodstvennikov 1-i stepeni rodstva patsientov s bolezn'iu Al'tsgeimera.

AIM: To evaluate the efficacy of course neurotrophic therapy with cerebrolysin in a group of first-degree relatives of Alzheimer's disease (AD) patients who had minimal cognitive dysfunction. MATERIAL AND METHODS: Sixty-seven relatives (mean age 57.6±14.2 y.o.) received cerebrolysin in the dose of 20 ml/day in intravenous drips in 100 ml isotonic saline. The duration of treatment was 1 month. RESULTS: The positive effect of course treatment on the CGI was established in 77.6% of the relatives. The scores on the MMSE and MoCA scales were significantly improved in the group with cognitive difficulties objectively confirmed by the clinical/neuropsychological examination (n=27) and in the group without cognitive difficulties (n=40). CONCLUSION: The positive effect of cerebrolysin on the cognitive status of the first-degree relatives of AD patients, regardless of their cognitive deficiency, was demonstrated.

[Clinical efficacy and safety of choline alfoscerate in the treatment of late-onset cognitive impairment]. / Klinicheskaia éffektivnost' i bezopasnost' primeneniia kholina al'fostserata v lechenii dodementnykh kognitivnykh narushenii v pozdnem vozraste.

AIM: To study the efficacy and safety of cereton (choline alfoscerate) in the treatment of elderly patients with amnestic type of mild cognitive impairment (aMCI), which often represents a pre-dementia (symptomatic) stage of Alzheimer's disease (AD). MATERIAL AND METHODS: Fifty patients (40 women and 10 men; mean age 68,8 years) received three-month therapy with cereton in a dose of 1200 mg/day in 3 divided doses. Fifteen patients received the same treatment again within 1 year. Immediate and delayed (7-9 months after treatment) effects of therapy, including those dependent on the ApoE genotype were assessed with a neuropsychological test battery. RESULTS: Psychometric measures showed a significant improvement after treatment with cereton. ApoE4 allele noncarriers performed better on tests of immediate and delayed reproduction of 10 words. Although, most indicators achieved in the end of therapy course decreased 7-9 months after treatment, the level of patients cognitive functioning remained at a higher level than before treatment. A repeated course of cereton treatment prevents cognitive deficit increasing during the follow-up period (10-12 months). CONCLUSION: The drug is well-tolerated and safe and can be recommended for preventive treatment of dementia in patients with high AD risk, in particular in elderly patients with aMCI syndrome.

[Anti-inflammatory effects of neurotrophic therapy (a pilot study)]. / Protivovospalitel'nye éffekty neirotroficheskoi terapii (primenenie tserebrolizina pri miagkom kognitivnom snizhenii).

AIM: To study clinical effects of cerebrolysin and its impact on systemic inflammation markers and immunity in mild cognitive impairment (MCI). MATERIAL AND METHODS: Twenty patients with MCI were treated with cerebrolysin administered intravenously during 4 weeks. Serum levels of immunoglobulins, inflammatory markers, neurotrophic factors were measured in dynamics in patients and controls using ELISA. RESULTS: An effect of cerebrolysin was found in MCI patients including the older group (mean age 78±1.1 years). An improvement was seen 6 and/or 22 weeks after treatment. Four types of response to neurotrophic treatment (fast long-term, fast short-term, delayed long-term), without effect were determined, the longer duration of positive effect of cerebrolysin was shown. There were differences in the indices of humoral immunity, clinical blood test results, cortisol and neurotrophin levels assessed before and after treatment between the patients with- and without positive effect of cerebrolysin. CONCLUSION: The high clinical effect of neurotrophic therapy with cerebrolysin in MCI shows its anti-inflammatory and immunotropic action that suggests the impact of cerebrolysin on the pathogenesis of MCI.

[Therapeutic monitoring and prediction of the efficacy of neurotrophic treatment in patients with amnestic type of mild cognitive impairment]. / Terapevticheskii monitoring i prognoz éffektivnosti neirotroficheskoi terapii u patsientov s sindromom miagkogo kognitivnogo snizheniia amnesticheskogo tipa.

AIM: To perform therapeutic monitoring and prediction of the neurotrophic therapy efficacy in patients with amnestic type of mild cognitive impairment (aMCI) in a model of course cerebrolysin therapy. MATERIAL AND METHODS: The study involved a group of 19 elderly patients who met the diagnostic criteria of aMCI. All patients received a course of neurotrophic therapy consisting of 20 intravenous infusions of cerebrolysin (30 ml of cerebrolysin in 100 ml of isotonic sodium chloride solution). To assess the therapy efficacy, psychometric scales (CGI, MMSE, MoCA-test, МDRS, FAB, Clock Drawing Test, BNT, Word Recall test, delayed reproduction of 10 words, naming digits in a direct and reverse order) were used at 0, 4, 10 and 26 weeks of the study. Antibodies to p75 neurotrophin receptor (NTR) were measured by ELISA in blood serum of 19 patients before cerebrolysin therapy and after 10 and 26 weeks of treatment. RESULTS AND CONCLUSION: The study showed that аMCI patients had an increased level of antibodies against P75NTR that was significantly decreased after 5.5 month of cerebrolysin treatment. Therefore, it can be a potential biomarker of long-term therapeutic effect of cerebrolysin treatment in aMCI patients. The modified fragment 155-164 of P75 NTR determined in the serum of patients can be an effective indicator for monitoring and predicting the efficacy of long-term neurotrophic therapy.

[Detection of effective treatment of amnestic mild cognitive impairement with cereton by testing of lipids markers]. / Issledovanie éffektivnosti tseretona pri miagkom kognitivnom snizhenii amnesticheskogo tipa na osnove testirovaniia markerov lipidnoi prirody.

AIM: Determination of effectivity and safety of Cereton (Choline alfoscerate, production by Sotex) 1200 mg/day in the treatment of cognitive functioning disorders in patients with amnestic mild cognitive impairment (aMCI) and determining its influence in the process (after a 3 month course of taking the drug) and 3 months after the end of treatment of aMCI on the change in the content of phosphatidylcholine, sphingomyelin, ceramide-metabolite sphingolipids and the activity of genes controlling the synthesis of enzymes, which control ithe metabolism of sphingomyelin and ceramide (sphingomyelinase and ceramidase). MATERIAL AND METHODS: The study involved a group of elderly patients (20 people), consisting of 14 women and 6 men, aged 51 to 82 years (mean age 70.3±9.1 years). The patients' condition met the criteria for diagnosing aMCI syndrome. Analysis of phosphatidylcholine, sphingomyelin and ceramide in the blood plasma of patients was carried out by thin layer chromatography, expression of sphingomyelinase and ceramidase genes by RtPCR. RESULTS AND CONCLUSION: A sharp increase in the content of phosphatidylcholine and ceramide, the product of sphingomyelin hydrolysis, was detected. Expression of genes (acidic sphingomyelinase and ceramidase), controlling the metabolism of ceramide, is significantly reduced in the majority of patients in the treatment with ceretone. An increase in the level of phosphatidylcholine and a decrease in the expression level of the ceramide metabolism genes during treatment with ceretone and other drugs that affect the metabolism of phosphatidylchodine and sphingolipids can be used as markers of the effectiveness of therapy.

[Clinical experience of the use of memantal in patients with moderate and severe Alzheimer's disease].

OBJECTIVE: To assess the efficacy and safety of memantal, a generic formulation of memantine, in patients with moderate and severe dementia due to Alzheimer's disease (AD). MATERIAL AND METHODS: Thirty patients with moderate and severe AD, aged from 55 to 84 years, were examined. Memantal was used in the dose of 20 mg per day after the titration period. Duration of treatment was 3 months. RESULTS: To the end of the study, there was a moderate positive effect as assessed by the CGI. During the treatment, cognitive functions and different forms of daily activity have improved. Significant positive changes in behavioral symptoms of dementia were noted. No adverse effects were observed during the treatment. CONCLUSION: The results of the analysis revealed the clinical efficacy and safety of memantal in treatment of AD.

[Levels of proinflammatory cytokines and vascular endothelial growth factor in patients with Alzheimer's disease and mild cognitive impairment]. / Uroven' provospalitel'nykh tsitokinov i faktora rosta VEGF u patsientov s bolezn'yu Al'tsgeimera i myagkim kognitivnym rasstroistvom.

OBJECTIVE: to evaluate the levels of cytokines (IFNα, IFNγ, IL-2, Il-4, IL-6, IL-8, IL-10, IL-12, IL-15), IL-1ß receptor antagonist (IL-1RA), vascular endothelial growth factor (VEGF) and its antagonist, the soluble form of receptor 1 (sVEGFR1) in the blood serum of patients with Alzheimer's disease, with early onset (ADEO) and late onset (ADLO), and in patients with mild cognitive impairment (MCI). MATERIAL AND METHODS: Levels of interleukins, IL-1RA, VEGF and sVEGFR1 were measured in 20 patients with AD and 11 patients with MCI using ELISA. These parameters were compared to the severity of cognitive impairment assessed by the performance on neurocognitive tests. RESULTS AND CONCLUSION: The levels of key cytokines (IL-8, TNFα, IL-12), VEGF and sVEGFR1 as well as anti-inflammatory proteins were different in patients with ADEO, ADLO and MCI. These differences suggest the phenotypic and genotypic heterogeneity of the disease that demands further research.

[The reduced level of antibodies to acetylcholine receptor alpha 7 fragment in the blood serum of patients with Alzheimer's disease].

OBJECTIVE: Determination of antibodies to neuronal membrane proteins in the blood serum of patients is of interest for diagnosis and optimization of treatment of Alzheimer's disease (AD). Authors studied the level of antibodies to acetylcholine receptor alpha 7 protein fragment (AChR), prion protein (РrР) and glycation end-products (RAGE) as well as to intracellular proteins nucleophosmin (Nuc) and survivin (Sur) in the serum of AD patients. MATERIAL AND METHODS: Serum samples of 26 patients with probable AD and 13 healthy people were studied. Exposed sections of each protein were used for the choice of peptides for antibody visualization. ELIZA was a main method in this study. RESULTS AND CONCLUSION: Antibodies to several proteins were identified but significant differences were found only for AChR-(173-193). The results demonstrated the involvement of AChR and AChR-antibodies in the development of AD. Determination of antibodies to AChR-(173-193) may be a marker of AD and a method for specifying the diagnosis of AD.

[Clinical experience with agomelatine for the treatment of depression in elderly patients in outpatient practice].

UNLABELLED: Objective. To determine the therapeutic efficacy and safety of agomelatine (valdoxan) in elderly patients with mild and moderate depression during outpatient treatment. Material and methods. The 60-79-year-old age group consisted of 20 patients with mild and moderate depressive episode who received agomelatine. Mild and moderate depressive episode was determined according to depressive disorder criteria of ICD-10. The therapeutic dose for agomelatine treatment was 25 or 50 mg/day once daily (in the evening) during 6 weeks. Results. Depressive symptoms reduced during the first 2 weeks of therapy with agomelatine. Agomelatine was effective in reducing both anxiety and depressive symptoms as well as significantly improved the health-related quality of the patient's life. Agomelatine did not negatively impact on cognitive function and had not pronounced and serious adverse events. CONCLUSION: Agomelatine can be recommended for use in clinical practice for the treatment of elderly outpatients with mild and moderate depression disorders.

[Efficacy of actovegin in the treatment of elderly patients with vascular mild cognitive impairment].

Efficacy of actovegin was investigated in the treatment of mild cognitive impairment (MCI) of cerebrovascular genesis. Thirty patients (7 men and 23 women, mean age 71.2 years) received actovegin intramuscularly in dosage 5 ml (200 mg) daily during 4 weeks. Patient's were assessed before and after treatment using CGI and MMSE, verbal association test, scale of frontal dysfunction, clock drawing test, Boston naming test, Mattis dementia scale, test to remember 10 words, the Hamilton depression scale. An improvement was seen in all measures. A positive therapeutic effect, including increased speed of mental processes, reduction of bradiphrenia and memory disorders as well as positive impact on asthenic and depressive symptoms, was identified. Side-effects and adverse events of actovegin were not observed. It is concluded that actovegin could be recommended for elderly patients with early manifestations of cognitive decline.

[Prognosis of cognitive deficit progression in aged patients with mild cognitive impairment under prolonged therapy (a three year observation)].

The aim of the study was to predict treatment efficacy in patients with mild cognitive impairment (MCI) and to find the most reliable clinical tests for the prediction of dementia. Patients with amnestic MCI (n=53) were treated with cerebrolysin for three years and underwent regularly neurocognitive and clinical psychiatric tests. The data were analyzed using non-parametric statistics, cluster analysis, and linear discriminate analysis. The combination of statistical methods has enabled to predict the degree of cognitive impairment as well as the development of dementia. A "dementia risk group" with fast cognitive decline (i.e. the low efficacy of the treatment) was identified. The tests are ranked according to their predictive values.

[Mental disorders of cognitive and non-cognitive spectrum in the first-degree relatives of patients with Alzheimer's disease].

Mental disorders of cognitive and non-cognitive spectrum in the first-degree relatives of patients with Alzheimer's disease (AD) were studied in 134 relatives, mean age 47.6 years, including 110 children and 24 siblings of probands. Compared to the age-matched controls (22 normals without relatives with AD), the higher frequency of the following mental disorders was found in the relatives: Alzheimer's phobia, irritable weakness, mild cognitive impairment, including difficulties in learning new information and reduced sustained attention due to tiredness (2 times more frequent), difficulties in recollection of remote events (1.4 times more frequent), signs of constitutional cognitive deficit in the anamnesis (2-4 times more frequent), the combinations of two or three types of cognitive deficits (3-4 times more frequent), the combination of communicating hydrocephalus with MRI signs of cerebrovascular pathology (3,4 times more frequent). The data obtained in the study can help develop treatment/ rehabilitation measures to prevent the progression of cognitive deficit.

[Efficacy, safety and tolerability of a single dose of akatinol memantine in comparison to two-doses in patients with moderately expressed and moderately severe dementia in Alzheimer's disease].

The compliance of patients with moderately expressed and moderately severe dementia, caused by Alzheimer's disease (AD), to the treatment with two different dose regimes of akatinol memantine was studied. The study included 40 patients with AD and mixed Alzheimer-vascular dementia (AD/VD) aged from 53 to 84 years. Patients were stratified into 2 groups: patients of group 1 received akatinol memantine in a single dose 20 mg in the morning and patients of group 2 received the drug twice in dose 10 mg in the morning and in the afternoon. The treatment duration was 24 weeks. The single dose of drug was as effective and safety as standard treatment with two doses. Therefore, treatment with a single dose of 20 mg akatinol memantine is recommended for clinical practice.