Comparative Assessment of Cognitive and Functional Impairments (MMSE, IADL, FAB) in Patients with Chronic Cerebral Ischemia of Cytomegalovirus Etiology

ABSTRACT INTRODUCTION. In recent years, Uzbekistan has demonstrated a steady increase in the prevalence of cerebrovascular pathology, particularly among middle-aged individuals and patients with comorbid chronic conditions such as arterial hypertension, diabetes mellitus, and metabolic syndrome. Despite ongoing preventive and therapeutic interventions, chronic cerebral ischemia remains one of the leading causes of early disability, cognitive impairment, and diminished quality of life. Clinical observations indicate that the contribution of viral infections – most notably cytomegalovirus (CMV) infection – to the pathogenesis of vascular disorders is frequently underestimated. This highlights the need to strengthen diagnostic awareness and integrate virological assessments into standard diagnostic algorithms. AIM. To investigate the impact of cytomegalovirus as an etiological factor of chronic cerebral ischemia on cerebral hemodynamics and cognitive impairment. MATERIALS AND METHODS. A total of 150 patients with chronic cerebral ischemia were examined between 2022 and 2024. All patients underwent a comprehensive assessment of cognitive status using the Mini-Mental State Examination (MMSE), the Instrumental Activities of Daily Living (IADL) scale, and the Frontal Assessment Battery (FAB). The evaluations were performed on the second day of inpatient treatment and repeated two months after the proposed comprehensive therapy. RESULTS AND DISCUSSION. Based on the obtained neuropsychological data, it is possible to draw a well-grounded conclusion that the presence of cytomegalovirus infection in patients with chronic cerebral ischemia exerts a significant aggravating effect on the course of the underlying disease. CMV infection, even in its latent or chronically active form, serves as an additional pathogenetic factor that exacerbates pre-existing vascular and metabolic disturbances, which in turn leads to worsening of clinical manifestations and acceleration of cognitive decline progression. CONCLUSION. In patients infected with CMV, a more pronounced decline in cognitive functions was observed, including frontalexecutive mechanisms, speech productivity, orientation, and the ability to maintain independent daily living activities. KEYWORDS: cognitive impairment, cytomegalovirus infection, neuropsychological assessment

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