Issue 24-6, 2025

Review

https://doi.org/10.38025/2078-1962-2025-24-6-118-130

Cerebrovascular Diseases and Adherence: a Cognitive Barrier to Achieving Treatment Goals. A Literature Review

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ORCIDAnna A. Kuzyukova*, ORCIDOlga I. Odarushchenko, ORCIDAnastasia Yu. Zagaynova, ORCIDMariam A. Simonyan, ORCIDLarisa A. Marchenkova

National Medical Research Center for Rehabilitation and Balneology, Moscow, Russia


ABSTRACT

INTRODUCTION. Cerebrovascular diseases (CVD), characterized by a progressive course, are widespread and are one of the leading causes of death worldwide. Patients with CVD have a high level of disability as a result of stroke and cognitive impairment (CI), up to dementia, which can negatively affect treatment adherence and become a barrier to recovery/prevention of further disease progression.

AIM. To examine the characteristics of CI and their impact on treatment adherence, the current possibilities for preventing severe CI, and methods aimed at improving adherence in patients with CVD and concomitant CI.

MATERIALS AND METHODS. Publications were identified through searches of the PubMed, Medline, and eLIBRARY.RU databases, including meta-analyses, review articles, and full-text publications. The search was conducted using the following keywords in Russian and English: cerebrovascular diseases, stroke, cognitive impairment, treatment commitment, cognitive rehabilitation. Emphasis was placed on publications from the last five years.

RESULTS AND DISCUSSION. The analysis showed that the presence of CI in patients with CVD may not only reduce treatment adherence among the patients themselves but also negatively influence medical decision-making. Control of vascular risk factors has little effect on cognitive functioning in patients with CVD. Timely diagnosis of CI, targeted pharmacological treatment, comprehensive cognitive rehabilitation approaches, and dietary strategies aimed at slowing the progression of CI may provide a significant benefit. Modern measures to improve adherence in patients with CVD and concomitant CI are aimed at actively involving relatives, educating healthcare professionals about the specific features of CI in CVD patients, improving doctor–patient communication, and actively implementing telemedicine

CONCLUSION. The problem of adherence to treatment in patients with CVD and concomitant CI remains highly relevant. However, the situation continues to evolve: existing and actively developing interventions aimed at improving adherence through the active involvement of relatives and healthcare professionals, and at early diagnosis, restoration, or slowing of CI progression, can significantly enhance compliance, rehabilitation potential, and the overall well-being of these patients.


KEYWORDS: cerebrovascular diseases, stroke, cognitive impairment, treatment adherence, cognitive rehabilitation, choline alfoscerate, idebenone

FOR CITATION: Kuzyukova A.A., Odarushchenko O.I., Zagaynova A.Yu., Simonyan M.A. Marchenkova L.A. Cerebrovascular Diseases and Adherence: a Cognitive Barrier to Achieving Treatment Goals. A Literature Review. Bulletin of Rehabilitation Medicine. 2025; 24(6):118–130. https://doi.org/10.38025/2078-1962-2025-24-6-118-130 (In Russ.).

FOR CORRESPONDENCE:

Anna A. Kuzyukova, Email: kuzyukovaaa@nmicrk.ru, anna_kuzyukova@mail.ru


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