The patient pathway in the diagnosis and treatment of mild cognitive impairment and new therapeutic opportunities. Resolution of the Expert Council (Moscow, April 21, 2025)

The Expert Council «The Patient Pathway in the Diagnosis and Treatment of Mild Cognitive Impairment (MCI) and New Therapeutic Opportunities» was held in Moscow on April 21, 2025. The purpose of the council was to discuss the challenges related to identifying patients with MCI and the long pathway to diagnosis. Experts discussed the diagnosis of MCI as well as new therapeutic opportunities for slowing the progression of dementia. The meeting was opened by Corresponding Member of the Russian Academy of Sciences, Prof. O.N. Tkacheva, who emphasized the burden of MCI in the Russian Federation (RF) and worldwide. Then, PhD E.A. Mkhitaryan and PhD M.A. Cherdak addressed the issue of MCI underdiagnosis at various stages of medical care. Prof. O.V. Kurushina and DSc Yu.V. Zhitkova presented data on cognitive impairment (CI) in specific regions of Russia. Prof. V.Yu. Lobzin provided data on the role of sleep disturbances in the development of CI, and Prof. A.N. Bogolepova discussed the use of the combination of melatonin 3 mg+memantine 5 mg, registered in the RF for the treatment of mild and moderate CI. Continuing the discussion on the place of this combination in clinical practice, Prof. O.D. Ostroumova presented patient profiles for whom this therapy is indicated. Prof. E.E. Vasenina outlined various approaches to the prevention and treatment of MCI. Prof. V.V. Zakharov discussed aspects of MCI pathogenesis. During the council, a discussion was held on defining clinical phenotypes of MCI patients and positioning the combination of melatonin 3 mg+memantine 5 mg (Miladean) considering its mechanism of action. As a result of the discussion, it was proposed to consider Miladean as part of pharmacological correction for pre-dementia cognitive impairment. Following the session, the moderators presented the participants with a draft resolution, which was revised according to comments and suggestions received. The final version of the resolution, published below, was approved by all members of the council.