Titel: Vaskulär kognitiv störning ett spektrum av sjukdomar [summary] (serie: Tema demens) 2009 nr 20 sid 1377-80
|
Summary:
Vascular cognitive impairment (VCI) is probably the most common form of acquired cognitive impairment. It needs to be better identified as it is a potentially treatable condition. Mild VCI appears in patients with various vascular diseases, for example congestive heart failure. When the cognitive impairment is pronounced the term dementia is used. Vascular dementia comprises various sub- or supertypes, such as subcortical vascular dementia, stroke-related dementia and mixed type dementia (Alzheimer's disease plus cerebrovascular disease). The clinical diagnoses are based on symptom assessment, with executive dysfunction being a characteristic finding, structural brain imaging, and cerebrospinal fluid determinations. There is not yet any approved pharmacological treatment of VCI and evidence for life style intervention as an efficient method is still lacking. Nevertheless, there is promising unapplied knowledge. If what is known about symptom presentation and subtypes of VCI is applied in the design of forthcoming trials, the probabilities of finding significant effects will increase.
Anders Wallin
Correspondence: Anders Wallin , Minnesmottagningen , Sahlgrenska Universitetssjukhuset, Wallinsgatan 6, SE-431 41 Mölndal, Sweden
anders.wallin@neuro.gu.se
Referenser:
1Sachdev P: Vascular cognitive disorder. Int J Geriatr Psychiatry 1999;14:402-403.
2Hachinski VC, Bowler JV: Vascular dementia. Neurology 1993;43:2159-2160.
3Rockwood K, Wentzel C, Hachinski V, Hogan DB, MacKnight C, McDowell I: Prevalence and outcomes of vascular cognitive impairment. Vascular cognitive impairment investigators of the canadian study of health and aging. Neurology 2000;54:447-451.
4Roman GC, Sachdev P, Royall DR, Bullock RA, Orgogozo JM, Lopez-Pousa S et al: A new diagnostic category updating vascular cognitive impairment and vascular dementia. J Neurol Sci 2004;226:81-87.
5Wallin A, Milos V, Sjogren M, Pantoni L, Erkinjuntti T: Classification and subtypes of vascular dementia. Int Psychogeriatr 2003;15 Suppl 1:27-37.
6O'Brien JT: Vascular cognitive impairment. Am J Geriatr Psychiatry 2006;14:724-733.
7Pressler SJ: Cognitive functioning and chronic heart failure: A review of the literature (2002-july 2007). J Cardiovasc Nurs 2008;23:239-249.
8Leblanc GG, Meschia JF, Stuss DT, Hachinski V: Genetics of vascular cognitive impairment: The opportunity and the challenges. Stroke 2006;37:248-255.
9Joutel A, Corpechot C, Ducros A, Vahedi K, Chabriat H, Mouton P et al: Notch3 mutations in cadasil, a hereditary adult-onset condition causing stroke and dementia. Nature 1996;383:707-710.
10Levy E, Carman MD, Fernandez-Madrid IJ, Power MD, Lieberburg I, van Duinen SG et al: Mutation of the alzheimer's disease amyloid gene in hereditary cerebral hemorrhage, dutch type. Science 1990;248:1124-1126.
11Sorrentino G, Migliaccio R, Bonavita V: Treatment of vascular dementia: The route of prevention. Eur Neurol 2008;60:217-223.
12Sachdev PS, Brodaty H, Valenzuela MJ, Lorentz L, Looi JC, Berman K, Ross A, Wen W, Zagami AS: Clinical determinants of dementia and mild cognitive impairment following ischaemic stroke: The sydney stroke study. Dement Geriatr Cogn Disord 2006;21:275-283.
13Nordlund A, Rolstad S, Klang O, Lind K, Hansen S, Wallin A: Cognitive profiles of mild cognitive impairment with and without vascular disease. Neuropsychology 2007;21:706-712.
14Erkinjuntti T, Inzitari D, Pantoni L, Wallin A, Scheltens P, Rockwood K et al: Research criteria for subcortical vascular dementia in clinical trials. J Neural Transm Suppl 2000;59:23-30.
15Roman GC, Erkinjuntti T, Wallin A, Pantoni L, Chui HC: Subcortical ischaemic vascular dementia. Lancet Neurol 2002;1:426-436.
16Reed BR, Mungas DM, Kramer JH, Ellis W, Vinters HV, Zarow C et al: Profiles of neuropsychological impairment in autopsy-defined alzheimer's disease and cerebrovascular disease. Brain 2007;130:731-739.
17Alexopoulos GS, Meyers BS, Young RC, Campbell S, Silbersweig D, Charlson M: 'vascular depression' hypothesis. Arch Gen Psychiatry 1997;54:915-922.
18Figueroa M, Tatemichi TK, Cross DT: Ct correlates of dementia after stroke. Neurology 1992;42:176.
19Gorelick PB, Chatterjee A, Patel D, Flowerdew G, Dollear W, Taber J, Harris Y: Cranial computed tomographic observations in multi-infarct dementia. A controlled study. Stroke 1992;23:804-811.
20Chui H: Dementia due to subcortical ischemic vascular disease. Clin Cornerstone 2001;3:40-51.
21Ferro JM, Madureira S: Age-related white matter changes and cognitive impairment. J Neurol Sci 2002;203-204:221-225.
22Inzitari D, Simoni M, Pracucci G, Poggesi A, Basile AM, Chabriat H et al: Risk of rapid global functional decline in elderly patients with severe cerebral age-related white matter changes: The ladis study. Arch Intern Med 2007;167:81-88.
23Schmidt R, Scheltens P, Erkinjuntti T, Pantoni L, Markus HS, Wallin A et al: White matter lesion progression: A surrogate endpoint for trials in cerebral small-vessel disease. Neurology 2004;63:139-144.
24Fein G, Di Sclafani V, Tanabe J, Cardenas V, Weiner MW, Jagust WJ et al: Hippocampal and cortical atrophy predict dementia in subcortical ischemic vascular disease. Neurology 2000;55:1626-1635.
25Wallin A, Pirttila T: Biomarkers in vascular dementia. In: Wahlund, Erkinjuntti, Gauthier (eds) Vascular Cogntive Impairment in Clinical Practice, Cambridge University Press, Cambridge, pp 77-92, 2009.
26Erkinjuntti T, Inzitari D, Pantoni L, Wallin A, Scheltens P, Rockwood K et al: Limitations of clinical criteria for the diagnosis of vascular dementia in clinical trials. Is a focus on subcortical vascular dementia a solution? Ann N Y Acad Sci 2000;903:262-272.
27Fredman P, Wallin A, Blennow K, Davidsson P, Gottfries CG, Svennerholm L: Sulfatide as a biochemical marker in cerebrospinal fluid of patients with vascular dementia. Acta Neurol Scand 1992;85:103-106.
28Tullberg M, Mansson JE, Fredman P, Lekman A, Blennow K, Ekman R et al: Csf sulfatide distinguishes between normal pressure hydrocephalus and subcortical arteriosclerotic encephalopathy. J Neurol Neurosurg Psychiatry 2000;69:74-81.
29Blennow K, Hampel H: CSF markers for incipient Alzheimer's disease. Lancet Neurol 2003;2:605-613.
30Sjögren M, Wallin A, Blennow K: Neurochemical markers. In: Vascular cognitive impairment: preventable dementia, J Bowler and V Hachinski, Editors 2003, Oxford university press: Oxford p 208-216
2003
31Wallin A, Sjogren M: Cerebrospinal fluid cytoskeleton proteins in patients with subcortical white-matter dementia. Mech Ageing Dev 2001;122:1937-1949.
32Sjogren M, Blomberg M, Jonsson M, Wahlund LO, Edman A, Lind K et al: Neurofilament protein in cerebrospinal fluid: A marker of white matter changes. J Neurosci Res 2001;66:510-516.
33Sjogren M, Minthon L, Davidsson P, Granerus AK, Clarberg A, Vanderstichele H et al: CSF levels of tau, beta-amyloid(1-42) and gap-43 in frontotemporal dementia, other types of dementia and normal aging. J Neural Transm 2000;107:563-579.
34Roman GC, Tatemichi TK, Erkinjuntti T, Cummings JL, Masdeu JC, Garcia JH et al: Vascular dementia: Diagnostic criteria for research studies. Report of the ninds-airen international workshop. Neurology 1993;43:250-260.
35McShane R, Areosa Sastre A, Minakaran N: Memantine for dementia. Cochrane Database Syst Rev 2006:CD003154.
36Malouf R, Birks J: Donepezil for vascular cognitive impairment. Cochrane Database Syst Rev 2004:CD004395.
37Craig D, Birks J: Galantamine for vascular cognitive impairment. Cochrane Database Syst Rev 2006:CD004746.
38Craig D, Birks J: Rivastigmine for vascular cognitive impairment. Cochrane Database Syst Rev 2005:CD004744.
39Lopez-Arrieta JM, Birks J: Nimodipine for primary degenerative, mixed and vascular dementia. Cochrane Database Syst Rev 2002:CD000147.
40Fioravanti M, Yanagi M: Cytidinediphosphocholine (cdp-choline) for cognitive and behavioural disturbances associated with chronic cerebral disorders in the elderly. Cochrane Database Syst Rev 2005:CD000269.
41Frampton M, Harvey RJ, Kirchner V: Propentofylline for dementia. Cochrane Database Syst Rev 2003:CD002853.
42McGuinness B, Todd S, Passmore P, Bullock R: The effects of blood pressure lowering on development of cognitive impairment and dementia in patients without apparent prior cerebrovascular disease. Cochrane Database Syst Rev 2006:CD004034.
43Areosa Sastre A, Grimley Evans J: No evidence that treatment or level of control of type ii diabetes influence cognitive function. Cochrane Database Syst Rev 2002:CD003804.
44Rands G, Orrell M, Spector A: Aspirin for vascular dementia. Cochrane Database Syst Rev 2000:CD001296.