The Role of Etiological Factors in the Development of Cognitive Impairments and the Development of Therapeutic Approaches in Patients With Chronic Cerebral Ischemia

Abstract

Chronic cerebral ischemia (CCI) is a progressively developing cerebrovascular condition that leads to long-term impairment of cognitive function due to sustained reductions in cerebral blood flow. Most prevalent among elderly populations, CCI is caused by a combination of vascular and metabolic disorders, including hypertension, atherosclerosis, diabetes mellitus, and chronic inflammation. These etiological factors contribute to neurodegenerative processes such as white matter lesions, hippocampal atrophy, and neuronal apoptosis, which manifest clinically as memory decline, reduced executive function, and attention deficits. This article presents a comprehensive analysis of the primary risk factors associated with CCI and their mechanisms of action in cognitive deterioration. It also reviews current therapeutic approaches, both pharmacological (antihypertensives, neuroprotective agents, antiplatelets) and non-pharmacological (cognitive rehabilitation, physical activity, diet), aimed at slowing disease progression and enhancing quality of life. The findings underscore the importance of early detection, interdisciplinary care, and integrated treatment strategies in effectively managing cognitive impairment in patients with chronic cerebral ischemia.