Clinical correlates of cognitive decline in vascular dementia

Robert H Paul; Ronald A Cohen; David J Moser; Brian R Ott; Manish Sethi; Lawrence Sweet; Jeff Browndyke; Paul Malloy; Kelly Garrett

doi:10.1097/00146965-200303000-00005

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Clinical correlates of cognitive decline in vascular dementia

Journal article

Peer reviewed

Clinical correlates of cognitive decline in vascular dementia

Robert H Paul, Ronald A Cohen, David J Moser, Brian R Ott, Manish Sethi, Lawrence Sweet, Jeff Browndyke, Paul Malloy and Kelly Garrett

Cognitive and behavioral neurology, Vol.16(1), pp.40-46

03/2003

DOI: 10.1097/00146965-200303000-00005

PMID: 14765000

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Abstract

To determine whether demographic data, dementia severity, functional status, whole brain volume (WBV), or subcortical hyperintensity volume (SH) predict subsequent cognitive decline in vascular dementia (VaD). The identification of variables that accurately predict progressive cognitive decline in dementia has important clinical implications. A cohort of 30 patients with VaD completed neurologic and neuropsychologic examinations and magnetic resonance imaging of the brain at baseline and again after 12 months. All participants met clinical and research criteria for VaD according to standard guidelines. Change scores were computed for measures of verbal fluency, verbal learning, and visual learning. Potential correlates of cognitive change included age, education, score on the Hachinski scale, WBV, SH, and functional ability. As a group, lower WBV and lower Hachinski score correlated with decline in verbal fluency and visual learning, whereas lower Hachinski score correlated with decline in verbal learning. However, when subdivided by disease type, this pattern held only for individuals with evidence of a cortical stroke at baseline. No clinical variables correlated with cognitive decline among individuals without a cortical infarction. Assessment of cognitive decline in VaD should be guided by dementia subtype, with particular attention directed at severity of cerebral atrophy rather than classic symptoms of infarction.

Severity of Illness Index

Predictive Value of Tests

Dementia, Vascular - complications

Double-Blind Method

Follow-Up Studies

Humans

Cerebral Cortex - pathology

Cognition Disorders - pathology

Dementia, Vascular - drug therapy

Nootropic Agents - therapeutic use

Brain Infarction - pathology

Basal Ganglia - pathology

Thalamus - pathology

Cytidine Diphosphate Choline - therapeutic use

Neuropsychological Tests

Cognition Disorders - diagnosis

Magnetic Resonance Imaging

Brain Infarction - complications

Analysis of Variance

Cognition Disorders - etiology

Brain - pathology

Dementia, Vascular - pathology

Aged

Body Weights and Measures

Details

Title: Subtitle: Clinical correlates of cognitive decline in vascular dementia
Creators: Robert H Paul - Brown Medical School, Providence, Rhode Island 20903, USA. Rpaul@lifespan.org
Ronald A Cohen
David J Moser
Brian R Ott
Manish Sethi
Lawrence Sweet
Jeff Browndyke
Paul Malloy
Kelly Garrett
Resource Type: Journal article
Publication Details: Cognitive and behavioral neurology, Vol.16(1), pp.40-46
Publisher: United States
DOI: 10.1097/00146965-200303000-00005
PMID: 14765000
ISSN: 1543-3633
eISSN: 1543-3641
Language: English
Date published: 03/2003
Academic Unit: Psychiatry; Medicine Administration
Record Identifier: 9984003928002771

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