[Comparative efficacy and safety of antidepressant mono- and multimodal therapy in elderly patients with depression (a clinical experience in a psychogeriatric hospital)].

Objective. A comparative evaluation of the efficacy and safety of a multimodal antidepressant therapy with venlafaxine plus cerebrolysin and monotherapy with the same antidepressant for the treatment of depression in elderly patients in a psychiatric hospital. Material and methods.

[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.

[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.

[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.

[Acetyl-L-carnitine (carnicetine) in the treatment of early stages of Alzheimer's disease and vascular dementia].

Efficacy, safety and tolerability of acetyl-L-carnitine (ALC) were studied during the double-blind placebo-controlled 12-week trial in patients with mild (initial) dementia caused by the Alzheimer's disease (AD) and vascular dementia (VD). ALC was administered in doses from 2250 to 3000 mg per day. Patient's state was assessed with some scales (MMSE, CGI etc) and a battery of neuropsychological tests.

[Ceraxon (citicoline) in the treatment of the mild cognitive impairment syndrome].

The objective was to study efficacy and safety of ceraxon (citicoline) used perorally in dose 1000 mg daily in the treatment of cognitive disturbances in patients with amnesic type of mild cognitive impairment (MCI). Twenty patients, aged from 50 to 90 years, received ceraxon in dose 1000 mg twice a day during 90 days. The state of patients was assessed with a battery of scales and tests with the following statistical data analysis.

[Possibilities of preventive treatment of Alzheimer's disease: results of the 3-year open prospective comparative study on efficacy and safety of the course therapy with cerebrolysin and cavinton in elderly patients with the syndrome of mild cognitive impairment].

The study was conducted in 3 Russian centers (Moscow, St. Petersburg and Nizhniy Novgorod). The total sample included 110 patients whose mental state met the definition of <> (MCI).

[Galantamine (reminyl) in the treatment of severe Alzheimer's disease].

Twenty-five patients with Alzheimer's disease (AD) in moderate-severe and severe stages received galantamine in dosage 8 mg daily during the 1st month with the following increasing to 16 mg daily. Six patients received 24 mg per day from the 3rd month. The total duration of therapy was 26 weeks.

[The treatment of Alzheimer's disease in patients with comorbid somatic pathology].

To study efficacy and safety of cholinergic therapy in patients with Alzheimer's disease or combined Alzheimer's and vascular dementia and marked somatic pathology, 30 patients, aged from 54-85 years, with mild or moderate dementia have been studied. Patients were treated with rivastigmine (exelon) in dosage 3-12 mg daily during 3 months. The safety of the drug for patients with comorbid somatic pathology has been shown: during the treatment no severe aversive effects or strengthening of diseases of visceral organs were observed.

[The therapeutic potential of cerebrolysin in the preventive therapy of Alzheimer's disease].

A potential of prolonged 2-years course of cerebrolysin therapy with courses repeated every 6 months to slow down or prevent the transition of the syndrome of mild cognitive impairment, amnestic type, to clinically relevant dementia has been studied in the open comparative study of 73 patients divided into 2 groups, one of which included patients treated with cerebrolysin and another one those who did not receive this drug. The effect of the 2-years course therapy with cerebrolysin suggested by the authors has been proven. Such therapy allows to prevent the progression of cognitive deficit and development of dementia of Alzheimer's type.

[ApoE genotype and efficacy of neurotrophic and cholinergic therapy in Alzheimer's disease].

Correlation association between an ApoE4 genotype in patients with mild-moderate Alzheimer's disease and efficacy of neurotrophic (cerebrolysin) and cholinergic (exelon) therapy was studied in the groups of patients formed using case-control method. A 4-month treatment has shown that both types of therapy had a significant clinical effect, however clinical effect proved to be more higher and stable in patients treated with cerebrolysin. A number of responders in the cerebrolysin group was 1.

[Neuropsychological evaluation of long-term therapy of Alzheimer's disease using different cerebrolysin dosages].

An open comparative randomized clinico-neuropsychological study of 4 cerebrolysin treatment courses was conducted during 19 months. The differences in long-term effects of different medication dosages (10 and 30 ml) were revealed. The higher cerebrolysin dose was more effictive for cognitive functioning of patients.

[Social and environmental factors and mental health in the elderly].

The paper gives data on trends in the prevalence of mental disease and disorders incidence in old age groups for 10 years (1984-1994) and analyzes whether macro- and microsocial factors can affect mental health in the elderly. Clinical and epidemiological surveys of 1109 examinees aged 60 years and older residing in a limited Moscow area have yielded morbidity rates for mental disease and disorders (including those by sex and age) in the population. Diagnoses was rated according to the International Classification of Disease (ICD-10).

[EEG-mapping in Alzheimer-type dementias].

EEG topographic correlates of the severity and type of Alzheimer-type dementias have been studied in 21 patients with senile dementia (SD) and 18 with Alzheimer's disease (AD) who were subdivided into smaller groups by MMSE grades for the severity of dementia, as well as in 15 mentally normal elderly persons. EEC maps in SD and AD patients differed from those in normal subjects in increased theta-delta EEG spectral power and suppressed alpha-band power that was more pronounced in the left hemisphere in AD than in SD patients. AD and SD patients had also different EEG topographical changes with intensified cognitive dysfunctions.

[Longitudinal approaches to the problem of clinical heterogeneity of Alzheimer-type dementia].

A total of 160 patients with Alzheimer-type dementias (ATD), including 84 with Alzheimer's diseases (AD) and 76 with senile dementia (SD), were examined. The initial signs of the disease were analyzed by making a retrospective assessment of informative history data. The prospective follow-up involved clinical, neuropsychological and electrophysiological (EEC mapping, evoked potentials) studies by applying the standardized assessment of results.

[Clinical heterogeneity of dementia of the Alzheimer type].

Using clinico-psychopathological, clinico-neuropsychological and computer-aided tomography approaches, material differences were ascertained between groups of patients with Alzheimer's disease (AD) and senile dementia (SD) in terms of the clinical parameters, including the age at which the disease sets in; the disease standing; the build-up features of the patients; the frequency of diverse exogenous and environmental actions at the premorbid stage and at the disease debut; the psychopathological structure of dementia and the initial disease manifestations. The clinical differences indicated were in agreement with different structures of the neuropsychological syndrome marked by the impairment of higher mental functions in AD and SD and with different structures and topography of alterations in the medulla, discovered by means of computer-aided studies. The differences in the clinical and morphofunctional characteristics of AD and SD allow a conclusion that AD and SD are clinically independent disease entities within the framework of the common group of the Alzheimer's type dementias.

[Comparative clinico-genetic studies of senile dementia and Alzheimer's disease].

The families of 128 probands with senile dementia (SD) and Alzheimer's disease (AD) were entered into the study. The correlation between the familial and sporadic cases of the disease was established. A geneticomathematic analysis was employed to estimate the clinicogenealogical findings.

[Clinical picture of initial manifestations and the characteristics of the subsequent course of senile dementia].

Retrospective analysis of initial events in senile dementia was performed in patients examined while staying in hospital at the stage of clinically manifested dementia. The data indicated that psychopathological structure of initial stage of the disease is of prognostical value for later formshaping and the rate of progression of the disease.

[Prognosis of mild dementia based on catamnestic study of the population].

A clinico-catamnestic investigation of a group of patients with initial psychoorganic changes qualified at first examination as the "soft" dementia and "accelerated mental aging", attributed the states of "soft" dementia a high value in prediction of manifested senile dementia. Predictive value of a complex of signs classified as "accelerated mental aging" was ambiguous.

[Epidemiology of dementias in the middle-aged and elderly].

The authors analyze clinico-epidemiologic and statistical data on the incidence and nosological distribution of organic dementias in urban population of advanced age (60 years and over), including their correlation with the sex and age of the examined groups of population. The authors have determined parameters of the "registered" morbidity (0.7 per 1,000 individuals aged 60 years and over) and the incidence (3.