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Cambridge University Press 978-0-521-87537-0 - Vascular Cognitive Impairment in Clinical Practice Edited by Lars-Olof Wahlund, Timo Erkinjuntti and Serge Gauthier Index More information

Index

Ab see amyloid proteins vascular disease and 166–8, 169, 172, 187 acetazolamide 74 treatment 189 acetylcholinesterase see cholinergic system see also mixed dementia activities of daily living (ADL) 200–4 aMCI see mild cognitive impairment (MCI) AD see Alzheimer’s disease amyloid precursor protein (APP) 140, 181 ADAS-Cog (Alzheimer’s Disease Assessment Scale) 195 amyloid proteins 139–40 ADDTC (Alzheimer’s Disease Diagnostic and Treatment in AD 33, 84–5, 140, 188 Centers) diagnostic criteria 35, 36 after cardiac arrest 172 adipose tissue 222–4 cholesterol and 181, 224 age mutations 141–6 in clinical trial recruitment 227 in VaD 85, 188 cognitive changes 15, 24 see also cerebral amyloid angiopathy epidemiology of dementia 5, 161, 220 anesthetics 171 aggression 207, 212 angiitis 101–3 treatment 212–13 angular gyrus 7, 34 agitation 207, 208, 210 anticonvulsant drugs 212–13 treatment 212–13 antidepressant drugs 212 albumin 88 antihypertensive drugs 157–8, 171, 174, 180, 221–2 alcohol use 159, 183 anti-inflammatory drugs 158 allergic angiitis 102 antioxidants 160, 183 alternative therapies 211 antipsychotic drugs 213–14 Alzheimer’s disease (AD) anxiety 207 amyloid and 33, 84–5, 140, 188 anxiolytic drugs 213 cognitive impairment 48, 48–50, 51, 52, 55, 120 aorta, arteritis of 101 cognitive reserve 184 aphasia 38–9, 107 diagnosis apolipoprotein E (APOE) e4 allele 41, 155, 163, b-amyloid 84–5 167, 184 clinical criteria 4, 39 APP (amyloid precursor protein) 140, 181 differential (compared to VaD) 53, 55, 73–4, 185–7 Arctic mutation CAA 144 imaging 70, 71, 73–4, 75 aromatherapy 211 tau protein 85, 86 arterial dissection 100–1 hereditary 140, 146–50, 178 arteriosclerosis see atherosclerosis history 178 arteritis 101–3 preclinical phase 51 ARWMC (age-related white matter changes) risk factors 6, 83, 156, 158, 167, 179–84, 221 rating scale 63

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© Cambridge University Press www.cambridge.org Cambridge University Press 978-0-521-87537-0 - Vascular Cognitive Impairment in Clinical Practice Edited by Lars-Olof Wahlund, Timo Erkinjuntti and Serge Gauthier Index More information

236 Index

assessment methods CARASIL (cerebral autosomal recessive arteriopathy with activities of daily living 200–4 subcortical infarcts and leukoencephalopathy) 126 behavioral symptoms 208–10 carbamazepine 212 in clinical trials 195 cardiac arrest 172–3 cognition 54, 195 cardiac failure 170–1 WML in MRI scans 62–3 cardiovascular disease atherosclerosis 98–100, 123 atherosclerosis 98–100, 167 in AD 187 research areas 173–4 APOE4 and 167 as a risk factor for dementia 157, 163, 168, 182, 184 as a risk factor for dementia 157, 168–70 risk factors in common with dementia 166–8 stroke and 100, 106 carers 202, 208, 210 see also coronary artery bypass grafting support programs 203, 212 atrial fibrillation 157, 163, 168–74 CBF see cerebral blood flow cerebral amyloid angiopathy (CAA) 124, 151 behavioral symptoms 38–40, 121, 206–8 AD and 33, 140, 156, 188 assessment 208–10 b-amyloid and 139, 140, 141–6, 150 treatment 210–14 brain pathology 124, 156, 162, 188 Behçet’s disease 103 hereditary forms benzodiazepines 213 amyloid protein mutations 124, 141–6 Binswanger’s disease 38, 71, 82, 118 other 146–50 see also subcortical VaD stroke and 124 biomarkers 77, 88 see also amyloid proteins b-amyloid 84–5, 88, 140 cerebral atrophy 12, 17, 23, 65–7, 136, 162 of blood-brain barrier status 88 cerebral blood flow (CBF) 188, 214 homocysteine 40, 82–3, 88, 160 imaging 70, 71–4 hypercoagulability markers 81–2 cerebroretinal vasculopathy 126 of inflammation 83 cerebrospinal fluid (CSF) 41 of structural damage 86–7 b-amyloid 84–5 blood flow see cerebral blood flow cholesterol 181 blood pressure CSF/serum albumin ratio 88 antihypertensive treatment 157–8, 171, 174, 180, 221–2 inflammatory markers 84 as a risk factor 16–17, 157–8, 163, 179–80, 221 neurofilaments 87 blood-brain barrier 87–8, 181 NSE 86 body mass index 158, 181–2, 222–4, 226 sulfatide 87 border zone (watershed) infarcts 61, 98 tau protein 289.8b brain atrophy 12, 17, 23, 65–7, 136, 162 ubiquitin 86 BRI2-related dementias 149–50 cerebrovascular disease (CVD) 12 bright light therapy 211 aging and 12–13, 15–18, 24 British type familial dementia (FBD) 149–50 dementia and 3, 20–3, 23–4, 77, 156–7 buspirone 213 diagnosis of VaD/VCI 11–12, 36 MCI and 18–20 C-reactive protein (CRP) 83, 158 see also stroke, white matter lesions CAA see cerebral amyloid angiopathy children 225 CADASIL (cerebral autosomal dominant arteriopathy with cholesterol, high levels 158, 163, 180–1, 224–5 subcortical infarcts and leukoencephalopathy) 125–6 cholinergic system deficits 87, 188, 196, 207 cognitive impairment in 22, 37, 47 treatment 74, 196–7, 214 imaging 64, 74 Churg-Strauss syndrome 102 preclinical phase 53 classification see definitions and classification calcifications 59 clinical trial design 195, 226–8

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coagulation abnormalities, markers of 81–2 clinical criteria 4, 39 cognitive impairment imaging 70, 71, 73–4, 75 age-related changes 15 tau protein 86–7, 86 assessment scales 54, 195 differential 48–50, 53, 55, 73–4, 105, 185–7 homocysteine and 83 mixed dementia 8–9, 33, 53, 81, 121, 186–7 mild (MCI) 14, 18–20, 120, 168, 186 VaD post-stroke 5 clinical criteria 7–8, 35–8, 121 pre-diagnosis 15–18, 51, 54–5, 56 complicating conditions 38–40 pre-stroke 34, 107, 163 imaging see imaging treatment 196–7, 203 neurological signs 6, 40, 120 in VaD 20–3, 36, 39, 46 post-stroke 34–5, 36, 37, 59–61, 71 AD compared 22–3, 36–7, 48–50, 52, 55, 120 problems with 32–3, 35, 53–4 CADASIL 37, 47 subcortical VaD 34, 35, 38, 51, 61–4 post-stroke 6, 36, 37, 46, 48 tau protein 86 subcortical 7, 19–20, 47, 50, 80, 120–1 work-up 40–1 cognitive reserve 184 VCI 54 complementary medicine 211 diet 160, 182–4, 226 computed tomography (CT) 58, 62, 97 diffusion tensor imaging (DTI) 67, 135 computerized image analysis 71–3 disconnection syndrome 13 coronary artery bypass grafting (CABG) 171–2 donepezil 196–7 cortical VaD see post-stroke VaD dorsolateral prefrontal cortex (DLPFC) 14, 18, 20, 50 CSF see cerebrospinal ﬂuid Down syndrome 124 CT (computed tomography) 58, 62, 97 DSM-IV (Diagnostic and Statistical Manual of Mental CVD see cerebrovascular disease Disorders, 4th Edition) 35 cystatin C-related CAA 146–7 Dutch mutation CAA (HCHWA-D) 124, 143 cytokines 84 dysexecutive syndrome see executive dysfunction

D-dimer 81 elder abuse 210 Danish type familial dementia (FDD) 150 emotional lability 207 definitions and classification entorhinal complex 49 dementia 35–6 environmental strategies for treatment 203–4, 211 MCI 4, 186 epidemiology MID 3, 96, 118 age and dementia 5, 161, 220 mixed dementia 186 behavioral symptoms 206–8 post-stroke (large vessel, cortical) VaD 6, 95 VaD 5, 121 subcortical (small vessel) VaD 6–7, 119 CADASIL 125 VaD in general 3, 6, 11, 33, 77, 119, 118 post-stroke 5, 79, 161 VCI 3, 4, 11–12, 186 VCI 4 delirium 209 see also risk factors delusions 207, 209 episodic memory loss 14–15 Dementia Risk Score 189 AD 48 demyelination 87, 124 AD and VaD compared 49, 50 depression 40, 207, 208 preclinical phase 51–2, 53 treatment 212 VaD 48–50 diabetes mellitus 157–9, 163, 182, 222 subcortical 19–20, 37, 50, 120 see also metabolic syndrome WML and hippocampal atrophy compared 18–20 diagnosis see also cognitive impairment AD etat crible 64, 123 b-amyloid 84–5 ethnicity 161

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executive dysfunction 47–8 haloperidol 213 AD and VaD compared 49, 50 HCHWA-D (hereditary cerebral hemorrhage with episodic memory loss and 48 amyloidosis, Dutch type) 124, 143 in heart failure 170 HCHWA-I (hereditary cerebral hemorrhage with in subcortical VaD 7, 19–20, 80, 120 amyloidosis, Icelandic type) 146–7 exercise 159–60, 183, 211 heart failure 170–1 explicit memory 14–15 hereditary disorders see also episodic memory loss AD 140, 146, 178 CAA familial amyloidotic polyneuropathy (FAP) 148 amyloid protein mutations 124, 141–6 familial British dementia (FBD) 149–50 other 146–50 familial Danish dementia (FDD) 150 CADASIL 125–6 familial disorders see hereditary disorders cognitive impairment in 22, 37, 47 families see carers imaging 64, 74 fat preclinical phase 53 adipose tissue 222–4 CARASIL 126 dietary 160, 182–3 other small vessel disease 126 Fazekas rating scale for WML 63 retinopathies 126 fibrinogen 81–2 HERNS (hereditary endotheliopathy with retinopathy, fibrinogen degradation product 81 nephropathy and stroke) 126 Finnish type cerebral amyloidosis 147 high density lipoprotein (HDL) 180 Flemish mutation CAA 141–3 hippocampus 14, 18–20, 23, 49, 65, 196 fractal dimension analysis 73 histopathology frontal lobe amyloidosis 139–40 executive dysfunction and 47–8, 49–50 angiitis 101, 102, 103 white matter lesions 14, 17–18 arterial dissection 101 see also prefrontal cortex atherosclerosis 98 frontotemporal dementia 70, 74 CADASIL 125 functional decline 200–1 infarcts 97 moyamoya disease 103 gabapentin 212 subcortical VaD 122, 123, 124 galantamine 197–8 homocysteine 40, 82–3, 88, 160 gelsolin-related amyloidosis 147 HVR (hereditary vascular retinopathy) 126 gender 161, 227 hyalinosis 122 genetics hypercholesterolemia 158–9, 163, 180–2, 224–5 CADASIL (NOTCH3 gene) 125 hypercoagulability, markers of 81–2 risk factors 174 hypertension for AD 167, 184 antihypertensive treatment 157–8, 171, 174, 180, apoE 41, 155, 163, 167, 184 221–2 common to cardiovascular disease and as a risk factor 16–17, 157–8, 163, 179–80, 221 dementia 167–8 hypomania 207 for VaD 41, 155–6 hypoperfusion dementia 6 see also hereditary disorders see also cerebral blood flow giant cell arteritis 102 hypothermia 173 glial fibrillary acidic protein 84 Icelandic type cerebral amyloidosis 146–7 Hachinski ischemic score 96 ICF (International Classification of Functioning, hallucinations 207 Disability and Health) 200

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imaging microbleeds 59, 64, 132, 162 CT 58, 62, 97 microinfarcts 34, 123, 157, 171 in diagnostic work-up 40, 41, 58, 70, 185 see also silent infarcts MRI see magnetic resonance imaging MID see multi-infarct dementia PET 70, 74–5, 75 mild cognitive impairment (MCI) 4, 14, 120, 186 SPECT 70, 71–4 and atrial fibrillation leading to dementia 168 inflammation WML and hippocampal atrophy compared 18–20 angiitis 101–3 see also preclinical cognitive impairment markers 83, 158 mixed dementia 8, 179 as a risk factor 158–9, 171 diagnosis 8–9, 33, 53, 81, 121, 186–7 instrumental activities of daily living (IADL) 200–4 relative contributions of AD and CVD to cognitive insulin resistance syndrome 160, 182 impairment 22–3 interleukins 84 treatment 197–8, 198 Iowa mutation CAA 144–5 mood disorders 40, 207, 208 Italian mutation CAA (codon 693) 143–4 moyamoya disease 103 Italian/Spanish mutation CAA (codon 713) 145–6 MRI see magnetic resonance imaging multi-infarct dementia (MID) lacunar state 7, 63, 96, 119, 123 cognitive impairment 46–8, 48 see also subcortical VaD definition 3, 96, 118 large vessel VaD 95 pathology 104–5 see also post-stroke VaD see also post-stroke VaD leukoaraiosis 62, 131 myelin loss 87, 124 see also white matter lesions myocardial infarction 168–70 Lewy body dementia 73, 207 lifestyle risk factors 159–60, 182–3, 225–6 neurofilaments 87 lipoprotein-a 82 neuroimaging see imaging lumbar punctures 41 neuroleptic drugs 213–14 lymphomatoid granulomatosis 102 neurological signs CAA 124 magnetic resonance imaging (MRI) 67–8 VaD 6, 7, 40, 120 CADASIL 64 neuron-specific enolase (NSE) 86 cerebral atrophy 65–7, 162 Neuropsychiatric Inventory 210 diagnostic criteria 59 NINDS-AIREN (National Institute of Neurological lacunes and microbleeds 59, 63–4, 162 Disorders and Stroke – Association Internationale pour large vessel infarcts 59, 59–61 la Recherche et l’Enseignement en Neurosciences) protocol 58–9 clinical criteria 7–8, 35, 36, 121 subcortical VaD 61–4, 67 proposed modification for subcortical VaD 51 white matter lesions 59, 62–3, 64, 67, 131, 162 radiological criteria 59 magnetization transfer imaging (MTI) 67, 135 NMDA receptor antagonists 198 matrix metalloproteinase 9 (MMP-9) 84 normal pressure hydrocephalus 38, 41 MCI see mild cognitive impairment NOTCH3/Notch3 125 medial temporal lobe atrophy 4, 21, 49, 162 NSE (neuron-specific enolase) 86 MRI 59, 61 nutrition 160, 182–3, 226 see also hippocampus memantine 198 obesity 158, 181–2, 222–4, 226 memory 14–15 olanzapine 214 see also episodic memory loss omega-3 fatty acids 183 metabolic syndrome 160, 182 oxysterols 181

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pain 209 psychosis 207, 209 Parkinson’s disease 38, 39 treatment 213–14 PET (positron emission tomography) 70, 74–5 phospho-tau protein 86 quetiapine 214 physical exercise 159–60, 183, 211 Piedmont mutation CAA 145 race 161 plasma markers see serum markers rehabilitation treatment 202–4 plasminogen-activator-inhibitor-1 (PAI-1) 82 research polyarteritis nodosa 102 cardiovascular disease and dementia 173–4 positron emission tomography (PET) 70, 74–5 clinical trial design 195, 226–8 post-stroke VaD progression of cognitive impairment and CVD 24, 54–5 clinical presentation 6 residential modifications 203–4, 211 cognitive impairment 6, 36, 37, 46, 48 retinal vasculopathy with cerebral leukodystrophy definition and classification 6, 95 (RVCL) 126 diagnosis risk factors clinical evaluation 34–5, 36, 37 for AD 6, 83, 156, 158, 167, 179–84, 221 imaging 59–61, 71, 97 biomarkers 81–2 epidemiology 5, 79, 161 blood pressure 16–17, 157–8, 163, 179–80, 221 pathology cardiovascular disease histology 97 as a risk factor for dementia 157, 163, 168, 182, 184 infarct location 61, 98, 105, 106 risk factors for 166–8 infarct number 104–5 cerebrovascular disease 156–7, 161–2 infarct volume 104 genetic see genetics, risk factors vessel disease 98–103 lifestyle 159–60, 182–3, 225–6 preclinical phase 51 metabolic 157–9, 160, 180–1, 182, 222–4 relationship between dementia and stroke 80, 106–14, prophylaxis and 189, 220 161–3 risk scores 160, 189 preclinical cognitive impairment stroke AD 51, 53, 179 as a risk factor for dementia 161–2, 163 VaD 51, 54–5, 56 risk factors for 82, 163 see also mild cognitive impairment for VaD 6, 41–2, 55, 81–2, 155 prefrontal cortex 14, 15, 17–18, 208 post-stroke 161–3 dorsolateral (DLPFC) 14, 18, 20, 50 risperidone 213, 214 presenilin 1 and 2 140, 146–50, 167 rivastigmine 198, 214 pre-stroke cognitive impairment 34, 107, 163 prevention selective serotonin reuptake inhibitors (SSRIs) 212 antihypertensive drugs 157–8, 171, 174, 180, 221–2 serum markers clinical trial design 226–8 b-amyloid 85 healthy lifestyle 159–60, 183, 225–6 CSF/serum albumin ratio 88 need for assessing individuals’ risk 189, 220, 225 homocysteine 40, 82–3, 88, 160 public health issues 220–1 NSE 86 statins 181, 225 sex (gender) 161, 227 prion diseases 148–9 silent infarcts 16, 162 prophylaxis see prevention see also microinfarcts prothrombin 82 single photon emission computed tomography (SPECT) pseudoxanthoma elasticum 126 70, 71–4, 75 psychological symptoms see behavioral SIVD (subcortical ischemic vascular disease and symptoms dementia) see subcortical VaD

Index 241

sleep disorders 211 tobacco use 159–60, 183 small vessel dementia see subcortical VaD transglutaminase 86 smoking 159, 183 transthyretin (TTR)-related amyloidosis 148 SPECT (single photon emission computed tomography) treatment 70, 71–4, 75 for AD or VaD 189 statins 181, 225 behavioral symptoms 210–14 statistical parameters 73 cognitive changes 196–7 strategic infarct dementia 7, 80, 96, 105 evaluation of 74, 195, 202 see also subcortical VaD functional decline 202–3 stroke pharmacological versus non-pharmacological 210–11, cognitive impairment after 5 212, 215 dementia after see post-stroke VaD support for carers 203, 212 homocysteine levels and 82, 83 see also prevention as a risk factor for VaD 161–2, 163 tricyclic antidepressants 212 risk factors for 82, 163 tumor necrosis factor-a (TNFa) 84 subcortical arteriosclerotic encephalopathy (SAE) 131 subcortical VaD ubiquitin 86 behavioral symptoms 208 biomarkers 82, 83, 87, 88 valproate 212 clinical presentation 6–7, 120–1 vascular cognitive impairment no dementia (vascular cognitive impairment 7, 19–20, 47, 50, 80, 120–1 CIND) 4 compared with AD 22–3, 36–7, 120 vascular cognitive impairment (VCI), definition 3, 4, definition and classification 6–7, 119 11–12, 186 diagnosis 34, 35, 38, 119 vascular reactivity 74, 75 imaging 61–4, 67, 71, 120 verbal episodic memory 49 mixed dementia and 121 verbal fluency 49, 52 new clinical criteria 51 Virchow-Robin spaces 64 hereditary vitamin supplements 160 CADASIL see CADASIL von Willebrand factor 82 CARASIL 126 other 126 watershed (border zone) infarcts 61, 98 retinopathies 126 weight 158, 181–2, 222–5, 226 pathology 118–19, 121–4 white matter lesions/hyperintensities (WML/WMH) preclinical 53 13–14, 131–2, 136 see also white matter lesions causes 132 sulfatide 87 cognitive impairment and 16, 17–18, 21–2, 34, surgery, cardiovascular 171–2 135–6 syndrome X see metabolic syndrome demyelination 87, 124 systemic lupus erythematosus (SLE) 103 imaging CT 62 Takayasu’s arteritis 101 DTI 135 tau protein 86–7, 88, 188 MRI 59, 62–3, 64, 67, 131, 162 technological aids in treatment 203–4, 211 MTI 67, 135 temporal arteritis 102 periventricular 62, 63, 124 temporal lobe see hippocampus, medial temporal lobe progression 132–3 atrophy as a risk factor 12, 156, 162 territorial infarcts 59, 98 subcortical 62, 63, 124 thalamus 21, 59, 63 working memory 14, 19