engleski

Vascular cognitive impairments

Vascular cognitive impairment (VCI) is a recent term describing a syndrome in which there is an evidence of stroke or subclinical vascular lesions and a cognitive impairment that affects at least one cognitive domain. Cerebrovascular disease can cause mild cognitive impairment or a severe form of vascular cognitive impairment called vascular dementia. Three specific elements are crucial for the diagnosis of this disorder: presence of cognitive impairment, presence of cerebrovascular disease and a logical time sequence of these two conditions. Brain imaging (CT, MRI) has to show some form of cerebrovascular pathological process, and the cognitive impairment has to occur within three months from cerebrovascular event. Mini Mental State Examination, Montreal Cognitive Assessment, Clock Drawing Test, NINDS-AIREN criteria and American Heart Assosiation/American Stroke Association criteria are used most often in routine diagnostics. When differentiating vascular dementia from Alzheimer's disease, Hachinski ischaemic scale is used. The dominating clinical features of vascular dementia are subcortical lesions with the impairments of executive functions (organizing, planning and sequencing), disoriented thoughts, actions or emotions, apathy and depression, impaired walking, while memory loss is mild. In the treatment of vascular dementia acetylsalicylic acid, piracetam, niacin, calcium channel blockers, cholinesterase inhibitors, memantine and other medicines are used, but their efficiency is still of restricted range. The prevention of vascular cognitive disorders includes modification and treatment of major cerebrovascular disease risk factors: arterial hypertension, hyperlipidemia, diabetes mellitus, obesity, insufficient physical activity, smoking, alcohol abuse, improper nutrition and other measures of primary and secondary prevention of cerebrovascular disorders.

Stroke; Cerebrovascular disease; Cognitive impairment; Dementia

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