Features of anxiety manifestation in older patients with different types of mild cognitive impairment

Author:

Sidenkova A.P.

Federal State Budgetary Educational Institution of Higher Education "Ural State Medical University" of the Ministry of Health of the Russian Federation, Yekaterinburg, Russia

Place of publication:

JOURNAL OF NEUROLOGY AND PSYCHIATRY, 11, 2017

The purpose of the study.

To study the structure of the anxiety symptom complex in elderly patients with amnestic, dysregulatory and polymodal types of mild cognitive impairment (MCI) and to determine the clinical efficacy of ethylmethylhydroxypyridine succinate (mexidol).

Material and methods.

A randomized study included 32 patients of both sexes over 55 years of age with MCI (ICD-10 F06.7) who sought medical help for anxiety. Inclusion criteria were compensation for concomitant somatic pathology, the absence of
significant stressful events during the past year, and the absence of depression. Clinical, psychopathological, and psychometric methods were used: the Hamilton Anxiety Rating Scale (HAM-A), the Geriatric Depression Inventory (GDS), the Mini-Mental State Examination (MMSE), the Clinical Global Impression Scale (CGI-S, CGI-I), and the Stressful Life Events Rating Scale. The main criterion for the effectiveness of 4-week therapy with Mexidol (375 mg per day) was a reduction in the total score on the HAM-A scale. Results and conclusion. At the time of inclusion in the study,
the average scores on the HAM-A and MMSE scales were 39.9 ± 3.18 and 25.7 ± 0.6, respectively. When studying the structure of the anxiety state in individuals with amnestic, dysregulatory, and polymodal types of MCI, it was found that the phenomenology of the anxiety symptom complex differs for these types of MCI. Repeated assessment of anxiety using the HAM-A scale was conducted after 1, 2, and 4 weeks of Mexidol therapy. Improvement in mental state was noted for all types of MCI, but the proportion of individuals with significant improvement was higher for the amnestic and dysregulatory types compared
to the polymodal type. The rate of development of the anti-anxiety effect was noted to be greater for the dysregulatory type of MCI. In all patients, the use of Mexidol contributed to an increase in the stability of attention function and the correction of autonomic dysfunction.

Key words: anxiety, mild cognitive impairment (MCI), neuropsychological types of MCI, mexidol.