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No. 3 (2025)

ORIRGINAL RESEARCH

Comparative Dynamics of Cognitive Functions in Blood Relatives of Patients with Alzheimer’s Disease During Neurometabolic Therapy

https://doi.org/10.48612/psyph/h734-fxhm-8pum

Published 2025-09-30

  • N.D. Selezneva
    • ,
  • I.F. Roshchina
    • ,
  • S.I. Gavrilova

N.D. Selezneva
Mental Health Research Center

I.F. Roshchina
Mental Health Research Center

S.I. Gavrilova
Mental Health Research Center

Abstract

The relevance of the problem of subjective cognitive decline (SCD) is due to the fact that the appearance of subjective complaints of cognitive decline is often an early predictor of the development of more pronounced disorders. SCD is considered a possible prodromal stage of Alzheimer’s disease (AD) and other dementias. Up to a quarter of people with SCD in subsequent years progress to a state of moderate cognitive impairment, and up to 10–15 % — to dementia.

The aim is a comparative assessment of the dynamics of cognitive functioning in groups of first-degree relatives of patients with AD with SCD who received a course of citicoline therapy and those who were not treated for 4 years and 9 months.

Materials and methods. An open comparative long-term study of the dynamics of cognitive functioning in the therapeutic (course therapy with citicoline) and control groups was conducted. The cohort included 106 people with SCD, who were first-degree relatives of patients with AD, of whom 40 (37.7 %) received long-term citicoline therapy (therapeutic group) and 66 (62.3 %) were not treated during the observation period (control group). Therapy method: 4 courses of oral citicoline therapy (1000 mg once a day in the morning for 3 months every 1.5 years). The following scales and tests were used to assess the dynamics of cognitive functioning: the Clinical Global Impression-Improvement (CGI-I) subscale, Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), 10-word memory test, Boston Naming Test (BNT), Wechsler Memory Scale-Revised (WMS-R, subtest 6), memory test for five geometric figures, Benton Visual Retention Test (BVRT), verbal fluency subtests («phonetic» and «categorical») from the Mattis Dementia Rating Scale (DRS), and the H. Munsterberg Test. Neuropsychological assessments employed an «Express method» for evaluating memory-intellectual functions. The cognitive status of patients was assessed during their visits to the geriatric psychiatry department of the Mental Health Research Center. A total of 8 visits were conducted: before and after each course of therapy. Initial indicators were compared with indicators after the end of 1, 2, 3, and 4 courses. In the control group, the assessment was carried out after 3, 21, 39, and 57 months of observation.

Results. According to the CGI-I subscale, by the end of the 4th course, a significant improvement was observed in 47.5 % of cases in the therapeutic group, indicating the reverse development of the SCD to the age norm. In the control group, at 57 months of observation, a deterioration was noted in 15.2 % of cases, corresponding to the conversion of the SCD to the syndrome of mild cognitive decline (MCI). According to the cognitive scales and tests in the therapeutic group, the average group scores significantly improved after each course of therapy, while in the control group, by 21 months of observation, the indicators of all scales and tests significantly decreased.

Conclusion. Repeated courses of oral procognitive therapy with citicoline (1000 mg daily for 3 months), administered at intervals of 1.5 years, effectively prevent cognitive deterioration among first-degree relatives of AD patients with SCD. The periodic neurometabolic therapy method using citicoline is recommended for inclusion in dementia prevention programs targeting high-risk individuals.

Keywords

Alzheimer's disease, first-degree relatives of Alzheimer's patients, subjective cognitive decline, prevention, citicoline

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