ЖурналыПодпискаАрхивКнигиПроектыО насРекламаДоставка/ОплатаКонтакты
+7 (495) 428-43-29
  • Главная
  • / Журналы
  • / Вернуться в журнал
  • / Содержание номера
  • / Статья
Современный взгляд на немедикаментозную коррекцию когнитивных нарушений

Современный взгляд на немедикаментозную коррекцию когнитивных нарушений

Авторы:
Екатерина Андреевна Коваленко,
Екатерина Владимировна Махнович,
Нина Алексеевна Осиновская,
Анна Николаевна Боголепова

Журнал: Журнал неврологии и психиатрии им. С.С. Корсакова. 2026;126(8):59-65.

DOI: 10.17116/jnevro202612608159

Прочитано: 72 раза

Резюме

Вопрос когнитивных нарушений (КН) приобретает растущее признание в качестве приоритетной проблемы общественного здравоохранения. Несмотря на активное изучение причин, механизмов и факторов риска развития КН, а также новых подходов медикаментозного лечения заболеваний, сопровождающихся развитием КН, далеко не всегда удается предупредить или замедлить развитие прогрессирующего когнитивного снижения с применением одной только фармакотерапии. Именно поэтому в тактике лечения пациентов с КН используются и нефармакологические методы поддержки когнитивного здоровья. В представленном обзоре литературы рассмотрены данные о наиболее эффективных методах немедикаментозной терапии КН, а также об их возможных комбинациях.

Ключевые слова

  • когнитивные нарушения
  • деменция
  • болезнь Альцгеймера немедикаментозная терапия
  • когнитивный тренинг
  • нейростимуляция
  • физические упражнения

Дата поступления: 04.05.2026

Дата принятия в печать: 24.05.2026

Дата публикации: 01.09.2026

Литература / References
  1. WHO. World failing to address dementia challenge. World Health Organization. September 2, 2021. Accessed August 21, 4, 2025. https://www.who.int/news/item/02-09-2021-world-failing-to-address-dementia-challenge
  2. Gustavsson A, Norton N, Fast T, et al. Global estimates on the number of persons across the Alzheimer’s disease continuum. Alzheimers Dement. 2023;19(2):658-670. https://doi.org/10.1002/alz.12694
  3. Wu X, Tang Y, He Y, et al. Prevalence of cognitive impairment and its related factors among Chinese older adults: an analysis based on the 2018 CHARLS data. Front Public Health. 2024;12:1500172. https://doi.org/10.3389/fpubh.2024.1500172
  4. Belleville S. Cognitive training for persons with mild cognitive impairment. International Psychogeriatrics. 2008;20(1):57-66. https://doi.org/10.1017/S104161020700631X
  5. Butler M, McCreedy E, Nelson VA, et al. Does Cognitive Training Prevent Cognitive Decline?: A Systematic Review. Ann Intern Med. 2018;168:63-68. https://doi.org/10.7326/M17-1531
  6. Zhu C, Arunogiri S, Li Q, et al. Cognitive Training During Midlife: A Systematic Review and Meta-Analysis. Neuropsychol Rev. 2025 Sep; 35(3):427-448. https://doi.org/10.1007/s11065-024-09649-z
  7. Paggetti A, Druda Y, Sciancalepore F, et al. Italian Dementia Guideline Working Group. The efficacy of cognitive stimulation, cognitive training, and cognitive rehabilitation for people living with dementia: a systematic review and meta-analysis. Geroscience. 2025;47(1):409-444. https://doi.org/10.1007/s11357-024-01400-z
  8. Szczepocka E, Mokros Ł, Kaźmierski J, et al. Virtual reality-based training may improve visual memory and some aspects of sustained attention among healthy older adults — preliminary results of a randomized controlled study. BMC Psychiatry. 2024;24:347. https://doi.org/10.1186/s12888-024-05811-2
  9. Na S, Lee SK, Lee TK, et al. The Effectiveness of VR-Based Cognitive Training Program for Mild Cognitive Impairment: A Pilot Study. Dement Neurocogn Disord. 2025;24(3):174-186. https://doi.org/10.12779/dnd.2025.24.3.174
  10. Yang Q, Zhang L, Chang F, et al. Virtual Reality Interventions for Older Adults With Mild Cognitive Impairment: Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Med Internet Res. 2025;27:e59195. https://doi.org/10.2196/59195
  11. Erickson KI, Hillman C, Stillman CM, et al. Physical Activity, Cognition, and Brain Outcomes: A Review of the 2018 Physical Activity Guidelines. Med Sci Sports Exerc. 2019;51(6):1242-1251. https://doi.org/10.1249/MSS.0000000000001936
  12. Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396(10248):413-446. https://doi.org/10.1016/S0140-6736(20)30367-6
  13. Iso-Markku P, Kujala UM, Knittle K, et al. Physical activity as a protective factor for dementia and Alzheimer’s disease: systematic review, meta-analysis and quality assessment of cohort and case-control studies. Br J Sports Med. 2022;56(12):701-709. https://doi.org/10.1136/bjsports-2021-104981
  14. Casas-Herrero A, Anton-Rodrigo I, Zambom-Ferraresi F, et al. Effect of a multicomponent exercise programme (VIVIFRAIL) on functional capacity in frail community elders with cognitive decline: study protocol for a randomized multicentre control trial. Trials. 2019;20(1):362. https://doi.org/10.1186/s13063-019-3426-0
  15. De Sá CA, Saretto CB, Cardoso AM, et al. Effects of a physical exercise or motor activity protocol on cognitive function, lipid profile, and BDNF levels in older adults with mild cognitive impairment. Mol Cell Biochem. 2024;479:499-509. https://doi.org/10.1007/s11010-023-04733-z
  16. Singh B, Bennett H, Miatke A, et al. Effectiveness of exercise for improving cognition, memory and executive function: a systematic umbrella review and meta-meta-analysis. Br J Sports Med. 2025;59(12):866-876. https://doi.org/10.1136/bjsports-2024-108589
  17. Liu K, Zhao W, Li C, et al. The effects of high-intensity interval training on cognitive performance: a systematic review and meta-analysis. Sci Rep. 2024;14(1):32082. https://doi.org/10.1038/s41598-024-83802-9
  18. Yau WW, Kirn DR, Rabin JS, et al. Physical activity as a modifiable risk factor in preclinical Alzheimer’s disease. Nat Med. 2025;31(12):4075-4083. https://doi.org/10.1038/s41591-025-03955-6
  19. Gogniat MA, Khan OA, Li J, et al. Increased sedentary behavior is associated with neurodegeneration and worse cognition in older adults over a 7-year period despite high levels of physical activity. Alzheimers Dement. 2025;21(5):e70157. https://doi.org/10.1002/alz.70157
  20. Kim SA, Shin D, Ham H, et al. Physical Activity, Alzheimer Plasma Biomarkers, and Cognition. JAMA Netw Open. 2025;8(3):e250096. https://doi.org/10.1001/jamanetworkopen.2025.0096
  21. Lazarou I, Parastatidis T, Tsolaki A, et al. International Ballroom Dancing Against Neurodegeneration: A Randomized Controlled Trial in Greek Community-Dwelling Elders With Mild Cognitive impairment. Am J Alzheimers Dis Other Demen. 2017;32(8):489-499. https://doi.org/10.1177/1533317517725813
  22. Fong Yan A, Nicholson LL, Ward RE, et al. The Effectiveness of Dance Interventions on Psychological and Cognitive Health Outcomes Compared with Other Forms of Physical Activity: A Systematic Review with Meta-analysis. Sports Med. 2024;54:1179-1205. https://doi.org/10.1007/s40279-023-01990-2
  23. Rajji TK. Transcranial Magnetic and Electrical Stimulation in Alzheimer’s Disease and Mild Cognitive Impairment: A Review of Randomized Controlled Trials. Clin Pharmacol Ther. 2019;106(4):776-780. https://doi.org/10.1002/cpt.1574
  24. Chen J, Wang Z, Chen Q, et al. Transcranial Direct Current Stimulation Enhances Cognitive Function in Patients with Mild Cognitive Impairment and Early/Mid Alzheimer’s Disease: A Systematic Review and Meta-Analysis. Brain Sci. 2022;12(5):562. https://doi.org/10.3390/brainsci12050562
  25. Manenti R, Sandrini M, Gobbi E, et al. Effects of Transcranial Direct Current Stimulation on Episodic Memory in Amnestic Mild Cognitive Impairment: A Pilot Study. J Gerontol B Psychol Sci Soc Sci. 2020;75(7):1403-1413.
  26. Cirillo G, Pepe R, Siciliano M, et al. Long-Term Neuromodulatory Effects of Repetitive Transcranial Magnetic Stimulation (rTMS) on Plasmatic Matrix Metalloproteinases (MMPs) Levels and Visuospatial Abilities in Mild Cognitive Impairment (MCI). Int J Mol Sci. 2023;24(4):3231. https://doi.org/10.3390/ijms24043231
  27. Begemann MJ, Brand BA, Ćurčić-Blake B, et al. Efficacy of non-invasive brain stimulation on cognitive functioning in brain disorders: a meta-analysis. Psychol Med. 2020;50(15):2465-2486. https://doi.org/10.1017/S0033291720003670
  28. Wen B, Han X, Gong J, et al. Nutrition: A non-negligible factor in the pathogenesis and treatment of Alzheimer’s disease. Alzheimers Dement. 2025;21(2):e14547. https://doi.org/10.1002/alz.14547
  29. Du Preez A, Lefèvre-Arbogast S, González-Domínguez R, et al. Association of dietary and nutritional factors with cognitive decline, dementia, and depressive symptomatology in older individuals according to a neurogenesis-centred biological susceptibility to brain ageing. Age Ageing. 2024;53(2):ii47-ii59. https://doi.org/10.1093/ageing/afae042
  30. Takeuchi H, Kawashima R. Diet and Dementia: A Prospective Study. Nutrients. 2021;13(12):4500. https://doi.org/10.3390/nu13124500
  31. Gard T, Hölzel BK, Lazar SW. The potential effects of meditation on age-related cognitive decline: a systematic review. Ann N Y Acad Sci. 2014;1307:89-103. https://doi.org/10.1111/nyas.12348
  32. Hodgins HS, Adair KC. Attentional processes and meditation. Conscious Cogn. 2010;19(4):872-878. https://doi.org/10.1016/j.concog.2010.04.002
  33. Hariprasad VR, Koparde V, Sivakumar PT, et al. Randomized clinical trial of yoga-based intervention in residents from elderly homes: Effects on cognitive function. Indian J Psychiatry. 2013;55(Suppl 3):S357-363. https://doi.org/10.4103/0019-5545.116308
  34. Guardabassi V, Maranesi A, Di Massimo M, et al. Are board games useful for people with dementia? A preliminary study for a non-pharmacological intervention. Front Psychol. 2025;16:1569406. https://doi.org/10.3389/fpsyg.2025.1569406
  35. Böttcher A, Zarucha A, Köbe T, et al. Musical Activity During Life Is Associated With Multi-Domain Cognitive and Brain Benefits in Older Adults. Front Psychol. 2022;13:945709. https://doi.org/10.3389/fpsyg.2022.945709
  36. Shinada T, Takahashi M, Uno A, et al. Effects of group music sessions on cognitive and psychological functions in healthy older adults. Front Aging. 2025;6:1513359. https://doi.org/10.3389/fragi.2025.1513359
  37. Seifert K, Spottke A, Fliessbach K. Effects of sculpture based art therapy in dementia patients-A pilot study. Heliyon. 2017;3(11):e00460. https://doi.org/10.1016/j.heliyon.2017.e00460
  38. Zhuo X, Yan Y, Lin R, et al. Effects of an art-based intervention in older adults with dementia: a randomized controlled trial. Sci Rep. 2025;15(1):10406. https://doi.org/10.1038/s41598-025-95051-5
  39. Elmasry J, Loo C, Martin D. A systematic review of transcranial electrical stimulation combined with cognitive training. Restor Neurol Neurosci. 2015;33(3):263-278. https://doi.org/10.3233/RNN-140473
  40. Simonsmeier BA, Grabner RH, Hein J, et al. Electrical brain stimulation (tES) improves learning more than performance: A meta-analysis. Neurosci Biobehav Rev. 2018;84:171-181. https://doi.org/10.1016/j.neubiorev.2017.11.001
  41. Martin DM, Liu R, Alonzo A, et al. Can transcranial direct current stimulation enhance outcomes from cognitive training? A randomized controlled trial in healthy participants. Int J Neuropsychopharmacol. 2013;16(9):1927-1936. https://doi.org/10.1017/S1461145713000539
  42. Yang T, Liu W, He J, et al. The cognitive effect of non-invasive brain stimulation combined with cognitive training in Alzheimer’s disease and mild cognitive impairment: a systematic review and meta-analysis. Alzheimers Res Ther. 2024;16(1):140. https://doi.org/10.1186/s13195-024-01505-9
  43. Antonenko D, Fromm AE, Thams F, et al. Cognitive training and brain stimulation in patients with cognitive impairment: a randomized controlled trial. Alzheimers Res Ther. 2024;16(1):6. https://doi.org/10.1186/s13195-024-01381-3
  44. Lauenroth A, Ioannidis AE, Teichmann B. Influence of combined physical and cognitive training on cognition: a systematic review. BMC Geriatr. 2016;16:141. https://doi.org/10.1186/s12877-016-0315-1
  45. Castellote-Caballero Y, Carcelén Fraile MDC, Aibar-Almazán A, et al. Effect of combined physical-cognitive training on the functional and cognitive capacity of older people with mild cognitive impairment: a randomized controlled trial. BMC Med. 2024;22(1):281. https://doi.org/10.1186/s12916-024-03469-x
  46. Besnier F, Dupuy EG, Gagnon C, et al. Effects of home-based exercise with or without cognitive training on cognition and mobility in cardiac patients: A randomized clinical trial. Geroscience. 2025;47(4):5651-5667. https://doi.org/10.1007/s11357-025-01530-y
  47. Chuang IC, Chen IC, Su KH, et al. The effects of high versus low frequency of combined physical and cognitive training on cognitive function in older adults with cognitive decline: a quasi-experimental study. BMC Geriatr. 2023;23(1):94. https://doi.org/10.1186/s12877-023-03802-8
  48. Nilsson J, Ekblom Ö, Ekblom M, et al. Acute increases in brain-derived neurotrophic factor in plasma following physical exercise relates to subsequent learning in older adults. Sci Rep. 2020;10(1):4395. https://doi.org/10.1038/s41598-020-60124-0
  49. Szuhany KL, Bugatti M, Otto MW. A meta-analytic review of the effects of exercise on brain-derived neurotrophic factor. J Psychiatr Res. 2015;60:56-64. https://doi.org/10.1016/j.jpsychires.2014.10.003
  50. Fritsch B, Reis J, Martinowich K, et al. Direct current stimulation promotes BDNF-dependent synaptic plasticity: potential implications for motor learning. Neuron. 2010;66(2):198-204. https://doi.org/10.1016/j.neuron.2010.03.035
  51. Dinoff A, Herrmann N, Swardfager W, et al. The effect of acute exercise on blood concentrations of brain-derived neurotrophic factor in healthy adults: a meta-analysis. Eur J Neurosci. 2017;46(1):1635-1646. https://doi.org/10.1111/ejn.13603
  52. Talar K, Vetrovsky T, van Haren M, et al. The effects of aerobic exercise and transcranial direct current stimulation on cognitive function in older adults with and without cognitive impairment: A systematic review and meta-analysis. Ageing Res Rev. 2022;81:101738. https://doi.org/10.1016/j.arr.2022.101738
  53. Ward N, Paul E, Watson P, et al. Enhanced Learning through Multimodal Training: Evidence from a Comprehensive Cognitive, Physical Fitness, and Neuroscience Intervention. Sci Rep. 2017;7(1):5808. https://doi.org/10.1038/s41598-017-06237-5
  54. Del Felice A, Castiglia L, Formaggio E, et al. Personalized transcranial alternating current stimulation (tACS) and physical therapy to treat motor and cognitive symptoms in Parkinson’s disease: A randomized cross-over trial. NeuroImage: Clinical. 2019;22:101768. https://doi.org/10.1016/j.nicl.2019.101768
slide-cover

Рекомендуем статьи по данной теме:

Когнитивные нарушения у 2775 амбулаторных пациентов с артериальной гипертонией и ИБС: связь между показателями выживаемости и смертности по данным пятилетнего наблюдения.Кардиологический вестник. 2026;21(2):46-56

Начальные признаки когнитивных нарушений: определение, критерии диагностики.Журнал неврологии и психиатрии им. С.С. Корсакова. Спецвыпуски. 2026;126(4-2):23-28

Результаты программы по сохранению когнитивных навыков и психоэмоционального здоровья в Центрах московского долголетия.Журнал неврологии и психиатрии им. С.С. Корсакова. 2026;126(2):45-52

Новый взгляд на биомаркеры крови у пациентов с болезнью Альцгеймера.Журнал неврологии и психиатрии им. С.С. Корсакова. 2025;125(12):7-13

Кардиогенная деменция.Журнал неврологии и психиатрии им. С.С. Корсакова. 2025;125(8):43-49

Технология когнитивной реабилитации с использованием комбинации постурального тренинга и одномоментной когнитивной задачи в профилактике когнитивного дефицита после коронарного шунтирования.Кардиология и сердечно-сосудистая хирургия. 2025;18(4):418-427

Основные механизмы развития когнитивных нарушений.Журнал неврологии и психиатрии им. С.С. Корсакова. Спецвыпуски. 2025;125(4-2):13-18

Неинвазивные биомаркеры ранней диагностики болезни Альцгеймера в биологических жидкостях.Журнал неврологии и психиатрии им. С.С. Корсакова. 2025;125(1):8-16

Когнитивные нарушения у билингвистов при неврологических заболеваниях.Журнал неврологии и психиатрии им. С.С. Корсакова. 2024;124(12):26-29

Активация эндогенных механизмов саногенеза при когнитивных нарушениях при болезни церебральных мелких сосудов.Журнал неврологии и психиатрии им. С.С. Корсакова. 2024;124(12):7-13

Издательство «Медиа Сфера»
РекламаДоставка/ОплатаО насКонтактыОбучение для редакцийПолитика конфиденциальностиПолитика обработки персональных данныхПубличная оферта на реализацию издательской продукции
ЖурналыПодпискаАрхивКнигиПроекты
  • RuStore

© 1998-2026

  • Телефоны издательства:

  • +7 (495) 482-41-18
  • +7 (495) 482-43-29
  • Прямой телефон отдела подписки
    (только по вопросам заказов и доставки журналов)

  • +7 (800) 250-18-12
  • пн-пт с 10:00 до 18:00

  • Telegram
  • VK
info@mediasphera.ru
  • Почтовый адрес:

  • Издательство «Медиа Сфера»,
    а/я 54, Москва, Россия, 127238

  • RuStore

© 1998-2026