Vascular factors in the genesis of dementia and the optimization of patient management

The review considers the problem of cognitive impairment (CI) and dementia in patients from older age groups, as well as the safety of antidementia agents with a focus on adverse cardiovascular drug reactions. Special attention is paid to the role of cardiovascular risk factors in the genesis of CI and all types of dementia. It is emphasized that the treatment of patients with CI is primarily aimed at monitoring vascular risk factors, preventing stroke and progression of chronic cerebrovascular disease, and, therefore, improving cognitive functions. Postoperative cognitive dysfunction in elderly patients, in particular during coronary artery bypass surgery, is highlighted. Non-drug and drug measures to prevent the progression of CI and dementia are described in detail. The significant importance of multimorbidity and polypragmasia in elderly patients with dementia is noted; data on the cardiovascular safety of anti-dementia drugs are presented.