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Olga N Tkacheva,1 Nadezda K Runikhina,1 Valentina S Ostapenko,1 Natalia V Sharashkina,1 Elen A Mkhitaryan,1,2 Julia S Onuchina,1 Sergei N Lysenkov,1,3 Nikolai N Yakhno,2 Yan Press4–6 1Pirogov Russian National Medical University, The Russian Clinical Research Center for Gerontology, Moscow, Russia; 2Neurology Department, Sechenov First Moscow State Medical University, Moscow, Russia; 3Department of Evolution, Faculty of Biology, Lomonosov Moscow State University, Moscow, Russia; 4Department of Family Medicine, Siaal Research Center for Family Medicine and Primary Care, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; 5Yasski Clinic, Comprehensive Geriatric Assessment Unit, Clalit Health Services, Beer-Sheva, Israel; 6Unit for Community Geriatrics, Division of Health in the Community, Ben-Gurion University of the Negev, Beer-Sheva, Israel Background: Geriatric syndromes (GSs) are common in older adults and have a significant effect on their quality of life, disability, and use of health care resources. Few studies have assessed the prevalence of GSs in Russia. The aim of this study is to assess the prevalence of GSs among older adults living in the community in Moscow. Methods: A cross-sectional study was conducted in four community clinics in Moscow. A total of 1,220 patients completed a screening questionnaire, and 356 of them also underwent a comprehensive geriatric assessment (CGA). Results: The mean age of the 1,220 participants was 74.9±6.1 years; 75.5% were women. Based on the questionnaire, 58.3% reported visual or hearing impairment, 58.2% cognitive impairment, 46% mood disorder, 42% difficulty walking, 28.3% urinary incontinence, 21.3% traumatic falls (over the previous year), and 12.2% weight loss. The mean number of GSs per patient was 2.9±1.5. Based on CGA, a decline in Instrumental Activity of Daily Living score was identified in 34.8% of the patients, a risk of malnutrition (Mini-Nutritional Assessment score, 17–23.5) in 25.8%, probable cognitive impairment (Mini-Mental State Examination score 5) in 36.2%. On the whole, patients demonstrated good mobility (average walking speed, 1±0.2 m/s) and hand grip strength (23.9±6.4 kg in women and 39.1±8.3 kg in men), but poor balance (only 39.4% were able to maintain their balance on one leg for 10 s or more). Conclusion: The results of this study demonstrate a high prevalence of GSs among community-dwelling people aged 65 years and older in Moscow. The results provide a better understanding of the needs of older adults in Russia and can facilitate planning for medical and social assistance for this population. Keywords: geriatric syndromes, comprehensive geriatric assessment, questionnaire, community-dwelling, Russia

Olga N Tkacheva,1 Nadezda K Runikhina,1 Arkadiy L Vertkin,2 Irina V Voronina,1 Natalia V Sharashkina,1 Elen A Mkhitaryan,1 Valentina S Ostapenko,1 Elena A Prokhorovich,2 Tamar Freud,3 Yan Press3–5 1Russian Gerontology Clinical Research Center, Pirogov Russian National Research Medical University of Ministry of Healthcare of the Russian Federation, 2Moscow State University of Medicine and Dentistry named after AI Evdokimov, Moscow, Russia; 3Department of Family Medicine, Faculty of Health Sciences, Sial Family Medicine and Primary Care Research Center, Ben-Gurion University of the Negev, 4Comprehensive Geriatric Assessment Unit, Clalit Health Care Services, Yassky Clinic, 5Community-Based Geriatric Unit, Division of Community Health, Ben-Gurion University of the Negev, Beer-Sheva, Israel Background: Delirium, a common problem among hospitalized elderly patients, is not usually diagnosed by doctors for various reasons. The primary aim of this study was to evaluate the effect of a short training course on the identification of delirium and the diagnostic rate of delirium among hospitalized patients aged ≥65 years. The secondary aim was to identify the risk factors for delirium. Methods: A prospective study was conducted in an acute-care hospital in Moscow, Russia. Six doctors underwent a short training course on delirium. Data collected included assessment by the confusion assessment method for the intensive care units, sociodemographic data, functional state before hospitalization, comorbidity, and hospitalization indices (indication for hospitalization, stay in intensive care unit, results of laboratory tests, length of hospitalization, and in-hospital mortality). Results: Delirium was diagnosed in 13 of 181 patients (7.2%) who underwent assessment. Cognitive impairment was diagnosed more among patients with delirium (30.0% vs 6.1%, P=0.029); Charlson comorbidity index was higher (3.6±2.4 vs 2.3±1.8, P=0.013); and Barthel index was lower (43.5±34.5 vs 94.1±17.0, P=0.000). The length of hospitalization was longer for patients with delirium at 13.9±7.3 vs 8.8±4.6 days (P=0.0001), and two of the 13 patients with delirium died during hospitalization compared with none of the 168 patients without delirium (P=0.0001). Conclusion: Although the rate of delirium was relatively low compared with studies from the West, this study proves that an educational intervention among doctors can bring about a significant change in the diagnosis of the condition. Keywords: delirium, elderly, inpatients, Russia

This article presents the incidence of geriatric syndromes in patients with chronic heart failure 65 years of age and older, depending on cognitive status. At the Russian gerontological center, 149 people with confirmed chronic heart failure were selected according to the European criteria of 2021. In this sample, 50,3% of patients had mild cognitive impairment, and 17,5% had severe cognitive impairment. With age, the incidence and severity of cognitive impairment increased. Among patients with cognitive impairment, there were more patients with reduced basic and instrumental activities of daily living, with a high risk of malnutrition and malnutrition, frailty and patients with hearing loss. Also, as cognitive functions declined, the median score of the Barthel and Lawton index, the mini nutritional assessment, the short physical performance battery, the Lubben social network scale decreased, and the median of the Morse fall risk scale and the geriatric depression scale increased. The presence of hearing loss was associated with a 3,6-fold increase in the odds of being diagnosed with cognitive impairment, and the presence of frailty syndrome, basic dependence in daily life, or the risk of malnutrition by a 2,4-fold increase.

Cognitive impairment, which is highly prevalent, especially among older people, leads to a decrease in the quality of life of patients, impairment of daily activities, and an increased risk of dementia and mortality. Currently, much attention is paid to mild cognitive impairment. The article discusses diagnostic criteria and possible clinical variants of this syndrome. Given the high rate of progression of mild cognitive impairment to dementia, it is necessary to identify risk groups and carry out therapeutic preventive measures. Correction of potentially modifiable risk factors is considered as a promising direction of therapy. Sufficient physical and mental activity, proper diet, normalization of sleep, visual acuity and hearing are necessary. Preventing stroke and controlling vascular risk factors may reduce the risk of mild cognitive impairment progressing to dementia.

Cerebral amyloid angiopathy (CAA) is a progressive disease characterized by the deposition of β-amyloid in the walls of blood vessels in the brain, which leads to their damage and disruption of normal blood flow. Morphologically, CAA is characterized by both isolated lesions (microhemorrhages with the appearance of cortical superficial siderosis, lacunar infarctions) and widespread changes (hyperintensity of the deep and periventricular white matter, expansion of the perivascular spaces) of cortical and subcortical localization. CAA is considered a major cause of cognitive impairment and intracerebral microbleeds, especially in patients with Alzheimer's disease. The review presents modern ideas about the etiology, pathogenesis, clinical manifestations of CAA, and also outlines the provisions of the Boston principles of CAA, revised in 2022. Understanding the features of pathogenetic methods of CAA is crucial for adjusting the accuracy of diagnosis and developing treatment methods to preserve and prolong cognitive health.

Dementia is one of the main challenges to modern society. According to estimated data, as of 2019, there were 1.949.811 people living In Russia with dementia of various etiology. At the same time, there have been no large epidemiological studies of dementia in the Russian Federation. The article provides an overview of the available data on the epidemiology of cognitive impairment (CI) In Russia given from various sources. Not only estimated, but also available clinical data were analyzed. In general, the obtained prevalence values for CI are comparable to global values. Thus, in an epidemiological study of people over 60 years of age in a separate district of Moscow, the prevalence of dementia was 10.4%, Alzheimer's disease 4.5%. A study of outpatients aged 60 years and older showed a high prevalence of both dementia and non-dementia CI at general medical appointments (incidence of dementia 7.8%, MCI 49.6%). It has been shown that the problem of non-dementia CI is already relevant in people of pre-retirement age (the prevalence of non-dementia CI in patients 55-64 years old is 36.8-44.8%). Unique data obtained in a population of institutionalized centenarians (prevalence of dementia 69%), as well as data on the relationship of CI with both somatic and demographic factors are presented.

Objective: To conduct a meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy of Prospekta in the treatment of SCI of varying severity., Material and Methods: The meta-analysis included the results of RCTs of the efficacy of Prospekta in the treatment of VCI, the severity of which was assessed using the Montreal Cognitive Scale (MoCA). The pooled effect estimate included all publications of double-blind, placebo-controlled RCTs that provided sufficient MoCA efficacy data to support further statistical analysis. The main result of the meta-analysis was obtained for the final values of the efficacy indicator in the groups of patients receiving the drug Prospekta, in comparison with the placebo group., Results: A meta-analysis of the effectiveness of Prospekta in the treatment of SCI of varying severity was carried out based on data from 3 RCTs and 2 CTs involving 12.701 patients aged 18 years and older. When using the mixed models method, the effect size for the endpoint «change in total MoCA score from baseline to follow-up visit» was 3.4 points for Prospekta (2.7 points for placebo, p <0.0001); for the end point «∆ between changes in the total score on the MoCA scale while taking Prospekta and placebo» - 0.6736 points ( p <0.0001)., Conclusion: A statistically significant improvement in cognitive function according to the MoCA scale was demonstrated in patients with VCI using the drug Prospekta.

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.

Objective: To explore the experts' opinion on the feasibility of using Mini-Kog, MMSE and GPCOG tests for screening assessment of cognitive impairment in elderly and senile patients at the primary stage of medical care, as well as to compare different characteristics of these tests according to experts' opinion., Material and Methods: The survey of specialists was carried out on the basis of 6 Medical Centers. Prior to the survey, specialists tested cognitive functions in elderly and senile patients during routine visits undergoing routine admission using Mini-Kog, MMSE and GPCOG tests, as well as interviewed their relatives using the corresponding section of the GPCOG. During the survey, specialists filled out a special physician checklist containing items for indicating socio-demographic information and questions regarding the use of tests for assessing cognitive functions in elderly and senile patients in daily clinical practice., Results: The survey involved 40 specialists from different cities of Russia (mean age±SD - 38.6±14.3 years, 82.5% - women). Elderly and senile patients accounted for the predominant proportion (76-100%) of all followed-up patients. All physicians considered it important to conduct a cognitive assessment in elderly patients and they have to use various cognitive tests in their practice. According to most experts, among the Mini-Kog, MMSE and GPCOG tests, all three tools are informative, convenient and suitable for screening cognitive impairment in geriatric patients. The MMSE test is more informative and convenient. Mini-Kog, compared to the other two tools, is the simplest and most time-efficient tool that is also better perceived by patients. An advantage of the GPCOG is the possibility of participation of informants in the assessment of cognitive functions in older patients., Conclusion: The findings could be used in further research focused on improving the approaches for early detection of cognitive impairment in geriatric patients by primary care physicians.

Objective: Evaluation of the efficacy and safety of Prospect in the treatment of cognitive, behavioral and mental disorders in patients with vascular dementia (VSD)., Material and Methods: In a double-blind, placebo-controlled, parallel-group randomised clinical trial, 406 patients aged 60-85 years old with a diagnosis of mild/moderate vascular dementia (10-24 on the Mini-Mental State Examination (MMSE)) and without signs of depression (Cornell Scale for Depression in Dementia (CSDD) scores ≤10) were included. At Visit 1, complaints and medical history were collected, vital signs were recorded, cognitive impairment was assessed using MMSE and MoCA, NPI-C and CSDD were completed, and an MRI brain scan was performed. Patients were randomised into two groups: patients in group 1 received Prospekta in a dosage of 2 tablets two times a day for 24 weeks, and patients in group 2 received Placebo according to the study drug regimen., Results: Patients in both groups had no differences in demographic and baseline clinical characteristics. Administration of Prospekta for 24 weeks reduced cognitive impairment in patients with vascular dementia compared to the placebo group. The mean MoCA score increased from 17.0±3.6 [17.1±3.6] to 20.5±4.7 [20.4±4.7] in patients treated with Prospekta, whereas it increased from 17.3±3.7 [17.3±3.8] to 19.2±4.9 [19.2±5.0] in the Placebo group. Treatment with the medication also reduced the severity of neuropsychiatric symptoms as measured by the NPI-C scale. The mean score on this scale decreased from 57.0±26.7 [56.7±25.4] to 39.8±23.6 [39.8±23.5] in the Prospekta group and from 55.5±25.5 [55.3±24.4] to 42.8±27.6 [42.3±25.3] in the Placebo group. The difference in mean MoCA and NPI-C scores between the Prospekta and Placebo groups was statistically significant., Conclusion: Prospekta is an effective and safe drug for treating cognitive, behavioural and mental disturbances in patients with vascular dementia.

Postcovid syndrome (PCS) is a complex multifactorial clinical condition that is a frequent complication of COVID-19. The development of PCS does not depend on the severity of the initial infectious disease, it has a pronounced effect on the quality of life and is characterized by a tendency to a protracted course. In the context of the ongoing COVID-19 pandemic, the emergence of new variants of the SARS-CoV-2 virus, it is important to develop common approaches to the diagnosis and management of patients suffering from this medical condition. The review presents current data on the epidemiology, pathogenesis, clinical presentation, and diagnosis of the PCS. The approaches to therapy of PCS are discussed, as well as the role of Cortexin, taking into account both theoretical and accumulated clinical data.

Diagnosis and treatment of early forms of cognitive impairment: possibilities of influencing neuronal energy metabolism. Resolution of the Council of Experts.

The aging of the population and the associated increase in the share of cognitive impairments in the structure of a wide range of diseases are a serious challenge for modern healthcare. Difficulties in the treatment of cognitive disorders are determined by many factors, including the age of patients, comorbidity, forced polypragmasia and the adequacy of the dosage of drugs that restore cognitive activity. The experts discussed information about the therapeutic potential of the drug Cerebrolysin in the treatment of cognitive disorders of various origins, stated significant experience of its effective and safe use in many clinical studies in mild and moderate forms of dementia. At the same time, there was a lack of consistent and systematic data on the dosage regimen, frequency, and duration of use of the drug in different forms of cognitive impairment and the degree of their severity. The aim of the international council of experts was to determine the optimal dosage regimens of the drug Cerebrolysin in patients with various etiologies and severity of cognitive impairment. The result of the work was the approval of a unified scheme for the use of the drug Cerebrolysin, considering the severity of the disease and its duration.

Geriatric syndromes (GSs) and aging-associated diseases (AADs) are common side effects of aging. They are affecting the lives of millions of older adults and placing immense pressure on healthcare systems and economies worldwide. It is imperative to study the factors causing these conditions and develop a holistic framework for their management. The so-called long-lived individuals-people over the age of 90 who managed to retain much of their health and functionality-could be holding the key to understanding these factors and their health implications. We analyzed the health status and lifestyle of the long-lived individuals and identified risk factors for GSs. Family history greatly contributes to the health and prevention of cognitive decline in older adults. Lifestyle and certain socioeconomic factors such as education, the age of starting to work and retiring, job type and income level, physical activity, and hobby were also associated with certain GSs. Moreover, the levels of total protein, albumin, alpha-1 globulins, high-density lipoprotein, free triiodothyronine, and 25-hydroxyvitamin D were direct indicators of the current health status. The proposed mathematical model allows the prediction of successful aging based on family history, social and economic factors, and life-long physical activity (f1 score = 0.72, AUC = 0.68, precision = 0.83 and recall = 0.64).

Vitamin B 1 2 (cobalamin) deficiency is a common condition in the elderly. Contrary to the established point of view, the absence of hematological changes (macrocytic anemia) does not always necessarily exclude this condition. Damage of the nervous system with the development of a complex of neurological and mental disorders is observed even at borderline levels of vitamin in blood. It is known, that vitamin deficiency is important risk factor of dementia. Cobalamin deficiency can directly lead to cognitive damage or accelerate development of dementia due to the other brain pathology - Alzheimer's disease, vascular dementia. The review provides information on the biological role of cobalamin in the human body, the prevalence of vitamin deficiency, especially in the elderly patients, and methods of its diagnosis and management. Both traditional parenteral therapy regimens and the possibility of oral intake of cobalamin in the course of deficiency correction are discussed.

Material and Methods: Russian version of the General Practitioner's Assessment of Cognition (GPCOG) questionnaire-test was adapted in accordance with modern international recommendations, including the procedure of its consecutive translations, testing of the Russian version of the questionnaire as part of interviewing geriatric patients and their relatives, as well as expert evaluation of the Russian version by specialists and decentering., Results: The testing procedure involved 8 geriatric patients (age 61-77 years, men/women - 3/5), as well as their relatives/other close persons; 8 specialists participated in the questionnaire (age 24-52 years, all women). Based on the data of interviewing patients and their relatives, an acceptable indicator of the external validity of the Russian version of the tool was established, according to the results of the questionnaire of specialists, its substantive validity was confirmed. The results of testing the GPCOG questionnaire-test in the focus group of patients and the questionnaire of specialists made it possible to make changes for two tasks at the decentering stage, which made it possible to improve the equivalence of the instrument to its original version, taking into account the ethno-linguistic characteristics of the domestic population., Conclusions: In the process of linguistic and cultural adaptation, the final version of the GPCOG questionnaire-test In Russian was formed, equivalent to the original and corresponding to the ethnolinguistic features of the population. The use of GPCOG in domestic geriatric practice and scientific research is possible after testing the instrument in a population of elderly and senile patients with the participation of primary care specialists and evaluating the psychometric properties of the instrument - reliability, sensitivity and specificity within the validation procedure.

Objective: To assess the efficacy of sequential therapy with Mexidol and Mexidol FORTE 250 in comparison with placebo in patients of different age groups with chronic brain ischemia., Material and Methods: The study is sub-analysis of data of the international multicenter, randomized, double-blind, placebo-controlled study of sequential therapy in patients with chronic brain ischemia (MEMO), which included 318 patients (25% men) in the age of 40-90 (median 60) years. All subjects were subdivided into 3 age subgroups: 40-60 years ( n =163), 61-75 years ( n =141) and 76-90 years ( n =13). The primary efficacy endpoint was the dynamic of increase of total score by MoCA scale, i.e. the absolute value of difference by MoCA scale at the point of day 75 comparing to values before treatment. As secondary efficacy endpoints results of dynamic by following questionnaires and scales were used: digit symbol substitution test, the Health Survey SF-36, asthenia subjective assessment scale (MFI-20), Vane questionnaire, Beck anxiety scale, Tinetti scale., Results: After 75 days of treatment positive dynamic was revealed in cognitive, emotional and motor impairment in patients of 40-60 and 61-75 age subgroups both in groups of Mexidol and placebo, but in group of Mexidol the changes were more prominent which is proved by significantly higher values of median of absolute difference of total score of studied parameters., Conclusion: The results of trial showed that in patients of different age-subgroups with chronic brain ischemia the improvement in cognitive, motor impairment and quality of life, as well as decrease in vegetative impairment, asthenia and anxiety are observed after 75 days of treatment both in Mexidol and placebo group, but in Mexidol group these changes are more prominent. The data obtained confirm the expediency of the use of sequential therapy with Mexidol and Mexidol FORTE 250 in patients of different age subgroups with chronic brain ischemia.

Cognitive impairment is one of the most common causes of reduced quality of life in older people. The aim of the study to evaluate impact of functional status, physical health and cognitive functions in women aged 55-64 years old. The study included 250 women aged 55-64 years (mean age 59,3±2,9 years). Socio-demographic and economic factors, functional and cognitive status were analyzed, the presence and prevalence of geriatric syndromes and their association with social, demographic and economic characteristics, risk factors for the development of chronic non-communicable diseases were studied. The prevalence of cognitive impairments was independently associated with education level, low income of patients, diabetes mellitus, glomerular filtration rate, and vertebral artery diameter. In this case, the level of education was a protective factor.

Aim: To evaluate the efficacy and safety of prolonged sequential therapy with mexidol in the acute and early recovery stages of hemispheric ischemic stroke (IS) across age groups according to the World Health Organization classification., Material and Methods: The study is an additional analysis across age groups among patients participated in the randomized double blind multicenter placebo-controlled, in parallel groups trial EPICA. All subjects (62 men and 88 women) were subdivided into age groups: younger than 60 years, 60-65 years, 76-90 years. Additionally, all participants were divided into 2 populations: ITT (Intent to treat population, patients who received at least one treatment/placebo dose) and PP (Per protocol population, patients who received treatment per study protocol). Results of Modified Rankin scale (mRs) at the end of treatment period, Barthel index, Beck depression inventory, European Quality of Life Questionnaire were assessed., Results: The efficacy of mexidol assessed with all the scales did not differ depending on the age group. By the end of treatment, the mean mRS score was lower in the 76-90 years subgroup (in both populations), compared to placebo ( p <0.001). The decrease in mean mRS score (Visit 1-5) was more prominent in patients aged 60-65 years ( p =0.025), including patients with diabetes mellitus (DM). Patients aged 76-90 years and patients with DM, compared to placebo, had a decrease of the severity of cognitive-affective depression symptoms ( p =0.049 and p =0.02) and an increase in patients without problems with everyday activities ( p =0.007 and p =0.02). Patients with DM, compared to placebo, also had the higher levels of everyday activity ( p =0.023) and quality of life ( p =0.045). There were no statistically significant differences in the frequency of side-effects in patients of all groups., Conclusion: It is recommended to include mexidol in therapy of patients with IS in the acute and early rehabilitation stages in all age groups, including patients with DM.

The paper presents original study results of cognitive changes associated with aging in the absence of neurodegenerative, vascular and other significant for cognition disorders in period from 50 to 85 years. It was shown that aging is associated with moderate memory decrease predominantly because of retrieval deficit but not acquisition insufficiency. It was also shown that aging is associated with non-severe executive dysfunction (lack of planning and control). According usual neuropsychological approaches pattern of cognitive changes described above reflects anterior cortical dysfunction or/and impaired interaction between frontal lobes and subcortical basal ganglia. Shows what physiological changes occur with age in the field of memory and executive functions, which is of great clinical importance for the differential diagnosis of normal aging and early stages of common in the elderly cerebral diseases.

For screening frailty in daily practice, we developed the questionnaire relating issues of weight loss, impaired vision and hearing, injuries related to falls, mood decline, cognitive impairment, urinary incontinence, and mobility difficulties. 356 outpatients from Moscow were included in the study (mean age 74,9±6,1 years, women - 80,4 %). Patients were interviewed using the questionnaire and underwent a comprehensive geriatric assessment. The phenotype model of frailty was determined by L. Fried criteria, the frailty index model - by K. Rockwood criteria. ROC-analysis demonstrated a satisfactory agreement between the result of the survey by the questionnaire and assessment the phenotype model of frailty and the frailty index model (AUC=0,765 and 0,731, respectively). The results statistically significantly correlated with the assessment of the phenotype model of frailty and the frailty index model (Spearman correlation = 0,4 and 0,41, p<0,001). Optimal characteristics of the questionnaire for the frailty screening were consistent to cut-off ≥3 and ≥ 4 points. We propose to use a cut-off ≥ 3 point, since it corresponds to a higher value of sensitivity (85,7 and 93,3 % compared with the phenotype model of frailty and the frailty index model respectively). The proportion of patients who scored ≥ 3 points (58,4 %) indicates a high prevalence of geriatric syndromes among outpatients in Moscow.

The efficacy of treatment with cerebrolysin was studied in 40 patients with cerebral vascular insufficiency. Cerebrolysin (20 daily i.v. infusions of 10 ml in 200 ml of physiological saline) was found to be an effective means of treating this group of patients. Courses of cerebrolysin treatment decreased the severity of memory and attention impairments, improving the overall cognitive status of the patients. Clinical observations and neuropsychological testing were supported by electrophysiological results, in terms of the P300 cognitive evoked potential. The effects of treatment at the doses used here were delayed and were seen three months after completion of treatment.

Neuropsychological studies of 50 patients with Lewy body dementia (LBD) and 50 patients with Alzheimer's disease (AD) were performed to assess the characteristics of the cognitive impairments in these diseases. In patients with dementias of similar severities, patients with LBD showed greater impairment of executive and visuospatial functions and had more marked neurodynamic dysfunction. Patients with AD showed more profound memory disorders.