Dementia and Geriatric Cognitive Disorders

Original Research Article

Vascular Cognitive Impairment: Prodromal Stages of Ischemic Vascular Dementia

Ramos-Estébanez C.a · Moral-Arce I.b · Muñoz-Arrondo R.c · González-Mandly A.d · Matorras-Galán P.e, f · González-Macias J.e, f · Hernández-Hernández J.L.e, f

Author affiliations

aAlbert Einstein College of Medicine, Internal Medicine Department, Center for Non-Invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Bronx, N.Y., USA; bSpanish National Institute of Statistics, Madrid; cDepartment of Neurology, Stroke Unit, Navarra Hospital, University of Navarra, Pamplona, dDepartment of Radiology, Division of Neuroradiology, Marques de Valdecilla University Hospital, eDepartment of Internal Medicine, Marques de Valdecilla University Hospital, University of Cantabaria, and fDepartment of Medicine and Psychiatry, University of Cantabaria, Santander, Spain

Keywords: LacuneBinswanger’s diseaseSilent ischemiaStrokeCognitive impairmentVascular dementia

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Dement Geriatr Cogn Disord 2008;25:451–460
https://doi.org/10.1159/000124753

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Article / Publication Details

First-Page Preview
Abstract of Original Research Article

Received: December 13, 2006
Accepted: August 30, 2007
Published online: April 10, 2008
Issue release date: April 2008

Number of Print Pages: 10
Number of Figures: 2
Number of Tables: 5

ISSN: 1420-8008 (Print)
eISSN: 1421-9824 (Online)

For additional information: https://www.karger.com/DEM

Abstract

Background/Aims: To describe the natural history of the prodromal stages of ischemic vascular dementia (pVaD). Methods: A sample of 314 inpatients with pVaD or a clini- cal diagnosis of vascular dementia (VaD; lacunar state, Binswanger’s disease, pure cortical VaD, corticosubcortical and strategic infarctions) admitted to a teaching tertiary center during a 13-year period was assessed (retrospectively n = 88, prospectively n = 226). Prospective neuropsychological assessment consisted of Mini Mental State Examination, Revised Wechsler Adult Intelligence Scale, Exit-25, Trail Making tests, Blessed Dementia Scale and Camdex H, Global Depression Scale and Hamilton Depression Rating Scale tests. Univariate analysis and logistic regressions are displayed. Results: An unrecognized pVaD was related with a clinical onset with cognitive impairment no dementia (CIND) versus symptomatic cerebrovascular events (p < 0.0001), and with being under therapy with anticoagulant or antiplatelet agents (p < 0.01). Age <85 years at diagnosis of VaD (p < 0.01) correlated with a delayed pVaD diagnosis. CIND onset was associated with a longer prodromal stage (p < 0.01), no clinical strokes during pVaD (p < 0.001), silent ischemia (p < 0.01) and Binswanger’s disease (p < 0.01). Conclusions: Vascular cognitive impairment remains an underdiagnosed, yet treatable entity. A brief neuropsychological examination and informant interviews should become standard practice in elderly populations with vascular risk factors. Small-vessel disease is a prevalent condition with a distinct natural history.

© 2008 S. Karger AG, Basel



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Article / Publication Details

First-Page Preview
Abstract of Original Research Article

Received: December 13, 2006
Accepted: August 30, 2007
Published online: April 10, 2008
Issue release date: April 2008

Number of Print Pages: 10
Number of Figures: 2
Number of Tables: 5

ISSN: 1420-8008 (Print)
eISSN: 1421-9824 (Online)

For additional information: https://www.karger.com/DEM

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