Geriatrics - Vascular Dementia Flashcards
What is vascular dementia?
Group of syndromes of cognitive impairment due to ischaemia or haemorrhage secondary to cerebrovascular disease
How much does a stroke increase the risk of developing dementia by?
Double the risk
What are the main subtypes of vascular dementia?
Stroke-related
Multi infarct or single-infarct
Subcortical
Small vessel disease
Mixed dementia
VD and Alzheimer’s disease
What are the risk factors of vascular dementia?
- Previous stroke or TIA
- AF
- Hypertension
- Diabetes
- Hyperlipidaemia
- Smoking
- Obesity
- Coronary heart disease
- Family history
What rare condition can cause vascular dementia to be inherited?
CADASIL
Cerebral autosomal dominant arteriopathy with subcortical infarct and leukoencephalopathy
What pattern of deterioration do patients with vascular dementia have?
Stepwise deterioration
What symptoms do patients with vascular dementia present with?
- Memory disturbance
- Gait disturbance
- Speech disturbance
- Emotional disturbance
- Focal neurological abnormalities
- Attention difficulty
- Seizures
How is vascular dementia diagnosed?
- History and examination
- Formal screen for cognitive impairment
- Medical review to exclude medical cause
- MRI
What criteria should be used for vascular dementia diagnosis?
NINDS-AIREN
What is the general management of vascular dementia?
- Support to patients and carers
- Reduce risk factors to slow progression
- Cognitive stimiulation programmes
- Analgesia
- AChEis or Memantine if suspected Alzheimer’s, Parkinson’s or Lewy body dementia
Is aspirin used for vascular dementia?
No evidence showing aspirin is effective
