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[Transitional cognitive syndrome: Reconsidered classification of cognitive disorders]
O S Levin1, E E Vasenina1,2, O A Gankina1,2
1Russian Medical Academy of Continuous Professional Education, Moscow, Russia.
Objective:
To assess the prevalence of the transitional cognitive syndrome (TCS) and evaluate the effectiveness of neurocognitive training in elderly individuals presenting with cognitive symptoms.
Material And Methods:
The study enrolled 198 elderly individuals with cognitive impairment symptoms from the Memory Clinics of the Moscow Department of Health and the N.A. Alekseev Psychiatric Clinical Hospital No. 1. Of these, 111 participants were assigned to the intervention group and received neurocognitive training (rehabilitation), while 87 participants formed the comparison group and received follow-up only. Neuropsychological assessments were conducted at baseline and after 12 months of follow-up.
Results:
In this sample, TCS accounted for approximately 5% of all cognitive impairments and remained stable over the one-year follow-up period. Annually, about 7% of mild cognitive impairment cases progressed to TCS, while 11-16% of TCS cases advanced to more severe dementia, irrespective of neurorehabilitation. These findings suggest the presence of an active neurodegenerative process. Neurorehabilitation was effective in improving regulatory functions, including among elderly participants.
Conclusion:
The introduction of the TCS concept allows for more precise classification of patients at the transitional stage between mild cognitive impairment and dementia. This framework improves risk assessment for short-term progression to more severe cognitive impairment and provides clinical justification for pathogenetic therapy, including the use of Miladean. The TCS concept also supports patient management and reduces the stigma associated with diagnosis at this stage, which is significant for both patients and their families. Advanced age and concomitant diabetes mellitus were identified as the most significant adverse factors for cognitive impairment. The observed effectiveness of neurocognitive rehabilitation in patients aged 75 years and older indicates that rehabilitation should not be limited by age.
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