Influence of genetic and comorbid emotional-affective factors on pre-mild cognitive decline in middle-aged patients

Abstract

Recently, maximum attention has been drawn to the earliest forms of cognitive deficit - pre-mild cognitive decline (PMCD), which includes subjective (SjCD) and subtle cognitive decline (SCD), being the most promising in cognitive decline prevention.Objective: to assess the influence of genetic and comorbid emotional-affective factors on PMCD in middle-aged patients.Patients and methods. The study included 50 middle-aged people (60.76±9.5 years) with cognitive complaints. All patients underwent a cardiovascular assessment, including: biochemistry blood test (lipid profile, urea, glucose, vitamin В12, folic acid, homocysteine, thyroid hormones), duplex scan of the extracranial arteries, blood assay for АРОЕ4 determination, neuropsychological assessment with quantitative neuropsychological methods, emotional-affective background evaluation. In addition, magnetic resonance imaging (MRI) with morphometry of the hippocampus was performed in 20 patients.Results and discussion. Arterial hypertension, diabetes mellitus, and changes in laboratory parameters are significantly were more frequent in patients with SCD than patients with SjCD. The neuropsychological assessment showed maximum differences between SjCD and SCD groups in tests that evaluated reaction time (verbal fluency test, trail making test, part A, digit symbol substitution test, and Munsterberg test). Analysis of neuroimaging parameters revealed a smaller volume of the right hippocampus in APOE4 carriers. patients without depression performed significantly better on memory tasks, when depression was included in the analysis. In addition, patients with depression showed a significantly more pronounced degree of cortical atrophy on MRI.Conclusion. Patients with SCD have lower scores in neuropsychological tests than patients with SjCD. In addition, we observed a high significance of cardiovascular and emotional-affective risk factors in the PMCD development, emphasizing the importance of their evaluation and treatment in the management of patients with PMCD.

Keywords

• pre-mild cognitive decline
• subjective cognitive decline
• subtle cognitive decline
• cognitive functions
• depression
• akatinol memantine