Vascular dementia: A construct in evolution
D.W. Desmond
Bok Engelsk 1996
| Utgitt | 1996
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| Omfang | Side 296- 325
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| Opplysninger | Since the late 1800s, when Alzheimer and Binswanger proposed theconcept of ''arteriosclerotic brain degeneration'' there has been anevolution in thinking regarding cerebrovascular disease (CVD) as abasis for dementia. While later work recognized the importance ofspecific infarct characteristics including volume, multiplicity, andlocation, recent studies have found that many factors may work incombination with those characteristics to produce dementia, includingwhite matter disease; vascular risk factors such as diabetes;comorbid illnesses, particularly those that might produce cerebralischemia or hypoxia; genetic factors; and host characteristics suchas older age and fewer years of education. Studies of the prevalenceof Macular dementia (VaD) have suggested that CVD is second only toAlzheimer's disease as a basis for dementia in Western countries andthe most common basis in certain Asian countries, but those studiesmay have underestimated the frequency of dementia associated with CVDdue to a failure to perform brain imaging and decreased survivalamong patients with CVD. Few studies of the incidence of VaD havebeen performed, but they have also consistently demonstrated anelevated risk associated with CVD. While certain methodologic issueshave contributed to the debate regarding the importance of CVD as abasis for dementia, including variability in the techniques that havebeen used to characterize brain lesions, assess cognitive function,and diagnose dementia; difficulties inherent in the determination ofa causal role for CVD in dementia; and the potential confoundingeffects of aphasia and depression in patients with stroke, it isclear that VaD remains an important public health problem.
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| Emner |
