engleski

Mild Cognitive Impairment In Symptomatic And Asymptomatic Cerebrovascular Disease

Mild cognitive impairment is a transitional stage between cognitive changes of normal aging and dementia, of both Alzheimers and vascular type. Evaluation of early signs of cognitive decline is important because many of the risk factors leading to cerebrovascular disease (CVD) can be managed medically in order to prevent severe cognitive impairment. Patients admitted to Department of Neurology due to first stroke or T1A (N=110, mean age 56&#177; 7 years) and subjects without signs of CVD but with vascular risk factors present (N=45, mean age 53&#177; 6, 0 years) were tested using MMSE and Montreal Cognitive Assessment (MoCA) on admission and retested after three and six months. All patients had no subjective or objective memory complaints prior to CVD symptoms. In all subjects data on vascular risk factors were recorded and brain CT, color duplex scan of carotid arteries with intima-media thickness (IMT) measurement were performed. TIA was diagnosed in 26 and lacunar stroke in 84 patients. In 70, 9%(78) patients multiple risk factors were present. Asymptomatic subjects most often had hypertension (AH), hyperlipoproteinaemia and diabetes. In all subjects initial MMSE was normal, in 47, 2%(52) patients and 24, 4%(11) asymptomatic subjects MoCA score was decreased (<26 points). Six months later, mean MoCA score in patients group was 19, mean MMSE was 26. Patients with stroke and multiple risk factors showed statistically significant cognitive decline compared to patients with TIA. Asymptomatic subjects with AH and increased IMT showed the greatest cognitive decline after six months, mostly in domains of attention, memory and calculation. We can conclude that patients with first stroke/TIA have increased risk of developing significant cognitive impairment. Using MoCA, discrete cognitive impairment is early registered even in asymptomatic persons with risk factors for CVD. Strong control of vascular risk factors among both symptomatic and asymptomatic patients is essential in prevention of severe vascular dementia.

Vascular dementia; MoCA test; Asymptomatic Cerebrovascular Disease

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