Vascular Dementia Flashcards
1
Q
What is vascular dementia?
A
A group of syndrome of cognitive impairment secondary to cerebrovascular disease - second most common form of dementia
2
Q
What are the risk factors for VD?
A
- History of stroke/TIA
- Older age
- HTN
- AF
- FH of stroke/CVD disease
- Obesity
- Smoking
3
Q
What are the 3 types of VD?
A
- Stroke related (infarct dementia)
- Subcortical VD (caused by small vessel disease)
- Mixed dementia (VD + Alzheimers)
4
Q
How does VD present?
A
- Stepwise deterioration of cognitive function
- Difficulty problem solving
- Apathy
- Slowed processing of information
- Poor attention
- Disinhibition
- Memory deficit
- Gait/Speech disturbance
5
Q
How is VD investigated?
A
- Comprehensive history and exam
- Full screen for cognitive impairment: FBC, TFTs, LFTs, B12
- MRI which may show infarcts and white matter changes
6
Q
What criteria should be used for VD?
A
NINDS-AIREN criteria
1. Cognitive decline which interfers with ADLs
2. CVD
3. Onset following stroke/stepwise deficits
7
Q
What is the management of VD?
A
- Symptomatic treatment
- Detect and address CVD risk factors
- Non pharmacological options include cognitive stimulation programmes, animal/art therapy
- Acetylcholinesterase inhibitors only recommended if have combined with Alzheimer’s
