Mild cognitive impairment of vascular origin: Proposal for an empirical approach in primary care
Main Article Content
Abstract
The incidence of mild cognitive impairment of vascular origin is increasing continuously among individuals with cardiovascular risk factors. The etiology of this kind of impairment is related to cerebrovascular pathologies, with the presence of silent cerebral infarctions the most relevant etiology. The incidence of cognitive impairment affects around 22% of patients at 3 months after an ischemic stroke, and this incidence is maintained or increased even 5 years after the stroke. Silent infarction should be considered the first clinical suspicion in patients with cardiovascular risk factors (such as hypertension, diabetes and dyslipidemia) who are attending a consultation for cognitive complaints, not only memory complaints. There are various tools for detecting such cognitive problems during the examination, such as brief cognitive tests and neuropsychological evaluations (for example, MMSE, SPMSQ or MoCA), and to assess its development. For a patient with cardiovascular risk factors and cognitive complaints it should be possible to carry out an empirical treatment and assess the development of the cognitive deficits before referring the patient to the specialist. This review outlines various attitudes and therapeutic possibilities that might be useful in the scope of Primary Care.
Article Details
How to Cite
SECADES, Julio J.
Mild cognitive impairment of vascular origin: Proposal for an empirical approach in primary care.
Medical Research Archives, [S.l.], v. 2, n. 6, oct. 2015.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/370>. Date accessed: 23 apr. 2024.
Keywords
Mild cognitive impairment. Cardiovascular risk factors. Evaluation. Therapy. Algorithm. Diagnosis.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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Cooper, C., Sommerlad, A., Lyketsos, C.G., & Livingston, G. (2015). Modifiable predictors of dementia in mild cognitive impairment: a systematic review and meta-analysis. Am J Psychiatry, 172(4), 323-334.
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Dal Pan, G., Stern, Y., Sano, M., & Mayeux, R. (1989). Clock-drawing in neurological disorders. Behav Neurol, 2(1), 39-48.
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DeKosky, S.T., Ikonomovic, M.D., Styren, S.D., Beckett, L., Wisniewski, S., Bennett, D.A, …Mufson, E.J. (2002). Upregulation of choline acetyltransferase activity in hippocampus and frontal cortex of elderly subjects with mild cognitive impairment. Ann Neurol, 51(2), 145-155.
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Douiri, A., Rudd, A.G., & Wolfe, C.D. (2013). Prevalence of poststroke cognitive impairment: South London Stroke Register 1995-2010. Stroke, 44(1), 138-145.
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Cytidinediphosphocholine (CDP-choline) for cognitive and behavioural disturbances associated with chronic cerebral disorders in the elderly. Cochrane Database of Systematic Reviews 2005, Issue 2. Art. No.: CD000269. DOI: 10.1002/14651858.CD000269.pub3.
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Gauthier, S., Reisberg, B., Zaudig, M., Petersen, R.C., Ritchie, K., Broich, K., …Winblad B; International Psychogeriatric Association Expert Conference on mild cognitive impairment. (2006). Mild cognitive impairment. Lancet, 367(9518), 1262-1270.
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Hachinski, V., Iadecola, C., Petersen, R.C., Breteler, M.M., Nyenhuis, D.L., Black, S.E., …Leblanc, G.G. (2006). National Institute of Neurological Disorders and Stroke-Canadian Stroke Network vascular cognitive impairment harmonization standards. Stroke, 37(9), 2220-2241.
Haring, B., Wu, C., Coker, L.H., Seth, A., Snetselaar, L., Manson, J.E., … Smoller, S. (2015). Hypertension, Dietary Sodium, and Cognitive Decline: Results From the Women's Health Initiative Memory Study. Am J Hypertens, pii hpv081.
Intzandt, B., Black, S.E., Lanctôt, K.L., Herrmann, N., Oh, P., & Middleton, L.E. (2015). Is Cardiac Rehabilitation Exercise Feasible for People with Mild Cognitive Impairment? Can Geriatr J, 18(2), 65-72.
Jekel, K., Damian, M., Wattmo, C., Hausner, L., Bullock, R., Connelly, P.J., …Frölich, L. (2015). Mild cognitive impairment and deficits in instrumental activities of daily living: a systematic review. Alzheimers Res Ther, 7(1), 17. doi: 10.1186/s13195-015-0099-0.
Jellinger, K.A. (2014). Pathogenesis and treatment of vascular cognitive impairment. Neurodegener Dis Manag, 4(6), 471-490.
Joosten, H., van Eersel, M.E., Gansevoort, R.T., Bilo, H.J., Slaets, J.P., & Izaks, G.J. (2013). Cardiovascular risk profile and cognitive function in young, middle-aged, and elderly subjects. Stroke, 44(6), 1543-1549.
Jorm, A.F. & Jacomb, P.A. (1989). The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): socio-demographic correlates, reliability, validity and some norms. Psychol Med, 19(4), 1015-1022.
Kaduszkiewicz, H., Eisele, M., Wiese, B., Prokein, J., Luppa, M., Luck, T., …Riedel-Heller, S.G. (2014). Prognosis of mild cognitive impairment in general practice: results of the German AgeCoDe study. Ann Fam Med, 12(2), 158-165.
Kalaria, R.N. (2012). Cerebrovascular disease and mechanisms of cognitive impairment: evidence from clinicopathological studies in humans. Stroke, 43(9), 2526-2534.
Kelley, B.J. (2015). Treatment of Mild Cognitive Impairment. Curr Treat Options Neurol, 17(9), 372. doi: 10.1007/s11940-015-0372-3.
Kim, S.A., & Jung, H. (2015). Prevention of cognitive impairment in the midlife women. J Menopausal Med, 21(1), 19-23.
López-Arrieta, J.M. & Birks, J. (2002). Nimodipine for primary degenerative, mixed and vascular dementia. Cochrane Database Syst Rev, 3, CD000147.
Luna-Lario, P., Azcárate-Jiménez, L., Seijas-Gómez, R., & Tirapu-Ustarroz, J. (2015). [Proposal for a neuropsychological cognitive evaluation battery for detecting and distinguishing between mild cognitive impairment and dementias]. Rev Neurol, 60(12), 553-561.
Mahmoudi, M.J., Hedayat, M., Sharifi, F., Mirarefin, M., Nazari, N., Mehrdad, N., …Fakhrzadeh, H. (2014). Effect of low dose ω-3 poly unsaturated fatty acids on cognitive status among older people: a double-blind randomized placebo-controlled study. J Diabetes Metab Disord, 13(1), 34. doi: 10.1186/2251-6581-13-34.
Makin, S.D., Turpin, S., Dennis, M.S., & Wardlaw, J.M. (2013). Cognitive impairment after lacunar stroke: systematic review and meta-analysis of incidence, prevalence and comparison with other stroke subtypes. J Neurol Neurosurg Psychiatry, 84(8), 893-900.
Mikhaĭlova, N.M., Selezneva, N.D., Kalyn, IaB., Roshchina, I.F., & Gavrilova, S.I. (2013). [Efficacy of actovegin in the treatment of elderly patients with vascular mild cognitive impairment]. Zh Nevrol Psikhiatr Im S S Korsakova, 113(7 Pt 2), 69-76.
Mitchell, J., Arnold, R., Dawson, K., Nestor, P.J., & Hodges, J.R. (2009) Outcome in subgroups of mild cognitive impairment (MCI) is highly predictable using a simple algorithm. J Neurol, 256(9), 1500-1509.
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