COMPOSITION (STRUCTURE) OF COGNITIVE IMPAIRMENTS IN CHRONIC CEREBRAL ISCHEMIA

Аннотация

Purpose. Study of the structure of neuropsychological damage depending on the stages of chronic cerebral ischemia (CCI), analysis of causes and factors. Materials and methods. 172 (100%) patients underwent neurological and neuropsychological examination. Patients were divided into 3 groups: 1st group - 62 (36.1%) patients with hypertension without pronounced CCI, 2nd group - 57 (33.1%) patients with stage 2 CCI with mild and moderate cognitive impairment, 3rd group - 53 (30.8%) patients with vascular dementia developed against the background of CCI. Neuropsychological examination using the DASS-21 (Depression, Anxiety, Stress Scale-21), HADS (Hospital Anxiety and Depression Scale), Spilberger Ch.D. and Khanin Yu.L. scales, Beck Depression Inventory (BDI), Montreal scale (MoSA), Addenbrooke's cognitive examination III, ACE-III) scales. Result. The study included patients aged 44 to 73 years. In the 3rd stage of CCI, in the state of dementia (3rd group), the number of men was higher, which indicates the rapid development of cognitive impairment in men compared to women, disability, and even mortality in men. According to the results of the DASS-21 scale, a low level of depression was characteristic of the 1st group, moderate and high levels were characteristic of the 2nd group, and in patients of the 3rd group, it was difficult to determine the cognitive state due to the presence of a degree of dementia. According to the HADS scale, the absence of anxiety in patients of group 1 was revealed, subclinical anxiety was almost equally distributed in all three groups, and severe anxiety was observed in almost half of the patients of group 2, which differed from both groups. According to the Spielberger and Khanin scale, the distribution of the average level of STAI-SHX and STAI-HX/RX in all three groups was practically the same, the strong level of STAI-SHX was less prevalent in group 3 than in group 1 (P<0.05), the strong level of STAI-HX/RX was more prevalent in group 2 than in group 1 (P<0.001). According to the BDI scale, mild, pronounced, and severe depressive states were identified in the main groups. When assessing the cognitive characteristics of patients according to the Montreal (MoCa) scale, mild, moderate, and severe cognitive impairment was observed in all three groups. We witnessed a decrease in the cognitive state depending on the stage of CCI. Conclusion. In chronic cerebral ischemia, which belongs to the category of cerebrovascular diseases, the cognitive and psychopathological state deepens with the development of the disease, these cognitive and psychopathological changes increase the possibility of determining the stage of the disease, in what and under what conditions to treat, which drugs to choose and provide adequate medical care, carrying out early prevention of the development of severe complications, and directing relatives of the patient for their care.