scholarly journals Vascular cognitive impairment : phenomenology, course, risk factors

2004 ◽  
Author(s):  
S.M.C. Rasquin
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Vascular Cognitive Impairment

Vascular cognitive impairment and vascular dementia

2018 ◽  
Vol 11 (5) ◽  
pp. 249-255
Author(s):  
Anne M. Bonnici-Mallia ◽  
Christopher Barbara ◽  
Rahul Rao
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Cardiovascular Risk ◽  
Vascular Dementia ◽  
Small Vessel Disease ◽  
Vascular Cognitive Impairment ◽  
Common Type ◽  
Social Unit ◽  
Vessel Disease ◽  
Diagnosis Of Dementia

Vascular dementia is the second-most-common type of dementia. Vascular cognitive impairment is a term encompassing vascular dementia as well as milder forms of pre-dementia cognitive impairment related to vascular damage that do not meet the criteria for a diagnosis of dementia. Early diagnosis of cerebrovascular disease, including silent infarcts and small vessel disease is difficult, but important, as modification of cardiovascular risk factors is the mainstay of management to decrease further insults and deterioration, and maintain the patient’s independence within their family and social unit.

scholarly journals Reshaping the path of vascular cognitive impairment with resistance training: a study protocol for a randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Teresa Liu-Ambrose ◽  
Elizabeth Dao ◽  
Rachel A. Crockett ◽  
Cindy K. Barha ◽  
Ryan S. Falck ◽  
...  
Keyword(s):  
Risk Factors ◽  
Randomized Controlled Trial ◽  
Cognitive Impairment ◽  
Cognitive Function ◽  
Resistance Training ◽  
Controlled Trial ◽  
Vascular Cognitive Impairment ◽  
Progressive Resistance Training ◽  
Randomized Controlled ◽  
Progressive Resistance

Abstract Background Subcortical ischemic vascular cognitive impairment (SIVCI) is the most common form of vascular cognitive impairment. Importantly, SIVCI is considered the most treatable form of cognitive impairment in older adults, due to its modifiable risk factors such as hypertension, diabetes mellitus, and hypercholesterolemia. Exercise training is a promising intervention to delay the progression of SIVCI, as it actively targets these cardiometabolic risk factors. Despite the demonstrated benefits of resistance training on cognitive function and emerging evidence suggesting resistance training may reduce the progression of white matter hyperintensities (WMHs), research on SIVCI has predominantly focused on the use of aerobic exercise. Thus, the primary aim of this proof-of-concept randomized controlled trial is to investigate the efficacy of a 12-month, twice-weekly progressive resistance training program on cognitive function and WMH progression in adults with SIVCI. We will also assess the efficiency of the intervention. Methods Eighty-eight community-dwelling adults, aged > 55 years, with SIVCI from metropolitan Vancouver will be recruited to participate in this study. SIVCI will be determined by the presence of cognitive impairment (Montreal Cognitive Assessment < 26) and cerebral small vessel disease using computed tomography or magnetic resonance imaging. Participants will be randomly allocated to a twice-weekly exercise program of (1) progressive resistance training or (2) balance and tone training (i.e., active control). The primary outcomes are cognitive function measured by the Alzheimer’s Disease Assessment Scale-Cognitive-Plus (ADAS-Cog-13 with additional cognitive tests) and WMH progression. Discussion The burden of SIVCI is immense, and to our knowledge, this will be the first study to quantify the effect of progressive resistance training on cognitive function and WMH progression among adults with SIVCI. Slowing the rate of cognitive decline and WMH progression could preserve functional independence and quality of life. This could lead to reduced health care costs and avoidance of early institutional care. Trial registration ClinicalTrials.gov NCT02669394. Registered on February 1, 2016

Pathogenesis, Diagnosis, and Treatment of Vascular and Mixed Dementias

2013 ◽  
pp. 900-903
Author(s):  
Helena Chang Chui
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Cognitive Impairment ◽  
Mr Imaging ◽  
Early Identification ◽  
Late Life ◽  
Vascular Cognitive Impairment ◽  
Prevention And Treatment ◽  
The Brain ◽  
Alzheimer Pathology

This chapter addresses five common questions surrounding vascular cognitive impairment (VCI): pathogenesis, diagnostic accuracy, incidence and prevalence, relationship between VBI and Alzheimer disease (AD), and prevention/treatment. Although vascular cognitive impairment is considered to be the second most common form of cognitive impairment and dementia in late life, it can be argued that public health emphasis should be placed more on the prevention and treatment of vascular brain injury (VBI), which for example may be detectable by MR imaging. We review the historical syndromes and current diagnostic criteria, which have focused on defining various subtypes of VCI and have influenced estimates of incidence and prevalence. Recent neuropathological studies have highlighted the frequent concurrence of Alzheimer pathology and VBI in late life. Converging evidence suggests that AD and VBI impose differential but additive deleterious effects on cognitive function. The field is moving increasingly to earlier detection of the brain at risk using MR imaging, as well as to the early identification and treatment of vascular risk factors.

scholarly journals Therapeutic Issues in Vascular Dementia: Studies, Designs and Approaches

2007 ◽  
Vol 34 (S1) ◽  
pp. S125-S130 ◽  
Author(s):  
Sandra E. Black
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Vascular Dementia ◽  
Executive Dysfunction ◽  
Vascular Cognitive Impairment ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Trial Duration ◽  
Disease Heterogeneity ◽  
Cognitive Behavioural

Vascular dementia (VaD) is a heterogeneous disorder resulting from various cerebrovascular diseases (CVD) causing cognitive impairment that reflects severity and location of damage. Epidemiological studies suggest VaD is the second commonest cause of dementia, but autopsy series report that pure VaD is infrequent, while combined CVD and Alzheimer's Disease(AD) is likely the commonest pathological-dementia correlate. Both diseases share vascular risk factors and benefit from their treatment. The most widely used diagnostic criteria for VaD are highly specific but not sensitive. Vascular Cognitive Impairment (VCI) is a dynamic, evolving concept that embraces VaD, Vascular Cognitive Impairment No Dementia (VCIND) and mixed AD and CVD. Clinical trials to date have focused on probable and possible VaD with beneficial effects evident for different drug classes, including cholinergic agents and NMDA agonists. Limitations have included use of cognitive tools suitable for AD that are insensitive to executive dysfunction. Disease heterogeneity has not been adequately controlled and subtypes require further study. Diagnostic VaD criteria now 13 years old need updating. More homogeneous subgroups need to be defined and therapeutically targeted to improve cognitive-behavioural outcomes including optimal control of vascular risk factors. More sensitive testing of executive function outlined in recent VCI Harmonization criteria and longer trial duration are needed to discern meaningful effects. Imaging criteria must be well-defined, with centralized review and standardized protocols. Serial scanning with quantification of tissue atrophy and lesion burden is becoming feasible, and cognitive interventions, including rehabilitation pharmacotherapy, with drugs strategically coupled to cognitive -behavioural treatments, hold promise and need further development.

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