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Clinical manifestations in neuropathologically defined subgroups of vascular dementia
Author(s) -
Andin Ulla,
Gustafson Lars,
Brun Arne,
Passant Ulla
Publication year - 2006
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.1548
Subject(s) - dementia , vascular dementia , delirium , medicine , cardiology , disease , psychology , intensive care medicine
Aims To study cardio‐cerebrovascular disease and clinical features, such as falls, dizziness/unsteadiness, urinary incontinence, hallucinations/delusions and delirium in neuropathologically defined subgroups of vascular Dementia (VaD): pure Small Vessel Dementia (SVD), combined SVD and Alzheimer's disease (SVD‐AD), pure Large Vessel Dementia (LVD) and pure Hypoxic Hypoperfusive Dementia (HHD), and to analyse the clinical differences between these groups. Materials and Methods From 175 consecutive cases with neuropathologically verified VaD cases with pure SVD ( n = 36) and SVD‐AD ( n = 38) with varying severity of AD pathology were selected and studied with respect to cardio‐cerebrovascular and other clinical features. Furthermore, a comparison between pure SVD, pure LVD ( n = 7) and pure HHD ( n = 6) was made. Results Neither cardiovascular symptoms, hypertension, Transitoric Ischemic Attacks (TIA) nor complete cerebrovascular lesions (CVL) differed significantly between the pure SVD and SVD‐AD groups. However, a wide variation of clinical features were reported. The prevalence of cardiovascular features varied markedly in the pure groups, with the highest prevalence consistently found in the LVD group. Hypertension was common in the pure LVD and SVD‐groups, while it was a rare finding in the HHD‐group. TIA and/or CVL were, as expected, most common in the LVD‐group. Conclusion In conclusion, this longitudinal and retrospective study of VaD shows important clinical similarities as well as differences between pathologically defined subgroups. Hopefully these findings will contribute to a better understanding of etiopathogenetic and diagnostic issues and form a solid basis for possible treatment strategies in VaD. Copyright © 2006 John Wiley & Sons, Ltd.