The Journal of the Association of Physicians of India · 2014
'The spectrum of vascular dementia'--a retrospective study from South India.
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Chandra S R, Yadav Ravi, Puneeth C S, Saini Jitender, Issac Thomas Gregor
Аннотация
OBJECTIVES: Vascular dementia (VaD) is high in Indian population and is preventable to some extent but there is paucity of literature. Hence we decided to study the clinical and laboratory spectrum of VaD.
METHODS: It was retrospective hospital based study. The patients who satisfied Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV criteria) for VaD and age of more than 40 years were identified on the basis of case file code which is uniformly used by the hospital.
RESULTS: Of the 83 patients included, 72.3% (60) were males (mean age: 65.3 ± 8.6 years) and 27.3% (23) females (mean age: 65.7 ± 1.1 years). Mean age of the patients was 65.4 ± 9.2 years. Abrupt onset was seen in 42 (51%) patients and 41 (49%) had insidious onset. There was gradual progression in 48 (57.8%), stepwise progression in 33 (39.8%) and 2 patients had rapid progression. Naming impairment was seen in 64 (77.1%), visuospatial disorientation was present in 49 (59%), dyscalculia in 55 (66.3%), emotional lability in 26.5%. Hypertension was the single most important risk factor (71.1%) followed by smoking (46.9%) and dyslipidaemia (45.8%). Neuropsychological testing showed Executive function involvement in 18 (66.7%) followed by memory in 16 (59.3%) patients. The total white matter hyperintensity score (12.39 ± 6.73) significantly correlated with mini mental scores (r: -0.4; p: 0.02).
CONCLUSION: We found that in our patients with vascular dementia, gradual progression, naming impairment and small vessel disease in imaging were the most common abnormalities. Hypertension was the single most important risk factor.
METHODS: It was retrospective hospital based study. The patients who satisfied Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV criteria) for VaD and age of more than 40 years were identified on the basis of case file code which is uniformly used by the hospital.
RESULTS: Of the 83 patients included, 72.3% (60) were males (mean age: 65.3 ± 8.6 years) and 27.3% (23) females (mean age: 65.7 ± 1.1 years). Mean age of the patients was 65.4 ± 9.2 years. Abrupt onset was seen in 42 (51%) patients and 41 (49%) had insidious onset. There was gradual progression in 48 (57.8%), stepwise progression in 33 (39.8%) and 2 patients had rapid progression. Naming impairment was seen in 64 (77.1%), visuospatial disorientation was present in 49 (59%), dyscalculia in 55 (66.3%), emotional lability in 26.5%. Hypertension was the single most important risk factor (71.1%) followed by smoking (46.9%) and dyslipidaemia (45.8%). Neuropsychological testing showed Executive function involvement in 18 (66.7%) followed by memory in 16 (59.3%) patients. The total white matter hyperintensity score (12.39 ± 6.73) significantly correlated with mini mental scores (r: -0.4; p: 0.02).
CONCLUSION: We found that in our patients with vascular dementia, gradual progression, naming impairment and small vessel disease in imaging were the most common abnormalities. Hypertension was the single most important risk factor.