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Sarah Fadlaini
Pembimbing : Dr. dr. Suherman, Sp.S(K)
INTRODUCTION
Vascular dementia (VaD) is a common type of dementia
that is affecting a growing number of elderly individuals
worldwide and it’s the second type that most caused
dementia (25%)
The cognitive profiles of different VaD subtypes depend
on the anatomical distribution of the vascular insults.
The aims of this study were to characterize cognitive
function profiles with respect to domain dysfunction in
different subtypes of VaD patients using
neuropsychological tests and assessing magnetic
resonance imaging (MRI) using well-defined radiological
criteria
MATERIAL & METHODS
Sample : 402 patients VaD between January 2002-June
2012 in our hospital
Inclusi :
1. Age ≥ 40 years;
2. Fulfillment of the NINDSAIREN criteria for probable VaD
3. MRI evidence of ischemic cerebrovascular disease,
including ischemic stroke or white matter lesions
4. Mini-Mental State Examination (MMSE) score of 10–26
5. modified Hachinski Ischemia Scale (HIS) score 4 or more
Variabel :
1. Demographic
2. Assessments of neurobehavioral function
Abstract thinking : Choynowski’s Memory Scale
Attention : Digit Span Forward test
Calculation : MMSE
Executive : trail-making test B (TMT-B)
Language : category naming of animals in 1 min
Mental control : revised Wechsler Memory Scale (WMS-R)
Neurobehavior : Neuropsychiatric Inventory (NPI)
Orientation : MMSE
Praxis-gnosis : Western Aphasia Battery ideomotor apraxia
subtest items
Visuospatial : MMSE
Subtype of VAD:
1. Small vessel VAD
2. Large vessel VAD
3. Mix-type vessel VAD
Statistical Analysis
1. Demographics : descriptive statistics
2. X² test and
3. One-way analysis of variance (ANOVA)
4. Newman-Keuls tests (NK)
RESULT
Demographics
Prevalence
Presentage of Cognitive Domain
DISCUSSION
Domain profile of cognitive dysfunction differs
among VaD subtypes, and that these subtypes are
associated with specific risk factors.
Preclinical period of the disease, when neuronal
degeneration has begun, but cellular and
biochemical damage is not yet sufficient for
symptoms to manifest, is the optimal time to initiate
a neuroprotective therapy
Location lesion = Cognitive domain
Medial temporal location is consistent with the
characteristic amnestic state in large-vessel VaD
Basal ganglia infarcts : executive dysfunction
Thalamus : memory impairment
Poor working memory and executive dysfunction in
subcortical VaD : frontal-subcortical circuits
VaD subtype cognitive profiles may be explained,
on one hand, by the anatomical distribution of the
vascular insults
Small artery disease : subcortical VaD (working
memory deficits, visuomotor speed and executive
dysfunction)
Neurotransmitters (acetylcholine) decreased in
dementia which is a potent vasodilator innervating
local cortical nitroxidergic interneurons, cerebral
capillaries and microarterioles
Acetylcholine esterase inhibitor : increased CBF
and could be used to treat dementia
Nonuniform cholinergic cortical innervation could
explain the regional profile variability in dementia
patients
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