Is the time ripe for new diagnostic criteria of cognitive impairment due to cerebrovascular disease? Consensus report of the International Congress on Vascular Dementia working group

BMC Medicine

Opinion

Antonio Federico¹  Oren Tene²  Panteleimon Giannakopoulos³  M. Arfan Ikram⁴  Johannes Attems⁵  Lefkos T. Middleton⁶  Robert Perneczky⁷  Marie Sarazin⁸ 

[1] Department of Medicine, Surgery and Neuroscience, University of Siena, Viale Bracci 2, 53100, Siena, Italy;Department of Psychiatry, Tel Aviv Sourasky Medical Center, Haim Weizman St 6, 64239, Tel Aviv-Yafo, Israel;Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, 69978, Tel Aviv, Israel;Department of Psychiatry, University of Geneva School of Medicine, 2 rue Verte, 1205, Geneva, Switzerland;Departments of Epidemiology, Radiology and Neurology, Erasmus MC, ‘s-Gravendijkwal 230, 3015, Rotterdam, CE, The Netherlands;Institute of Neuroscience, Newcastle University, Campus for Ageing and Vitality, NE4 5PL, Newcastle upon Tyne, UK;Neuroepidemiology and Ageing Research Unit, School of Public Health, Faculty of Medicine, The Imperial College of Science, Technology and Medicine, Charing Cross Hospital, St Dunstan’s Road, W6 8RP, London, UK;Neuroepidemiology and Ageing Research Unit, School of Public Health, Faculty of Medicine, The Imperial College of Science, Technology and Medicine, Charing Cross Hospital, St Dunstan’s Road, W6 8RP, London, UK;Department of Psychiatry and Psychotherapy, Technische Universität München, Ismaninger Str. 22, 81675, München, Germany;Cognitive Impairment and Dementia Service, West London Mental Health NHS Trust, Lakeside Mental Health Unit, West Middlesex University Hospital, Twickenham Road, TW7 6FY, London, UK;Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Nussbaumstr. 7, 80336, München, Germany;Unit of Neurology of Memory and Language, Centre de Psychiatrie et Neurosciences, INSERM UMR S894, Centre Hospitalier Sainte Anne and Université Paris Descartes, Sorbonne Paris Cité, 75013, Paris, France;

关键词: Cerebrovascular disease;    Dementia;    Cognition;    Biomarker;    Risk factor;    Neuroimaging;    Cerebrospinal fluid;    Magnetic resonance imaging;    Genetics;    CADASIL;   

DOI  :  10.1186/s12916-016-0719-y

 received in 2016-05-27, accepted in 2016-10-14,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundLong before Alzheimer’s disease was established as the leading cause of dementia in old age, cerebrovascular lesions were known to cause cognitive deterioration and associated disability. Since the middle of the last century, different diagnostic concepts for vascular dementia and related syndromes were put forward, yet no widely accepted diagnostic consensus exists to date.DiscussionSeveral international efforts, reviewed herein, are ongoing to define cognitive impairment due to cerebrovascular disease in its different stages and subtypes. The role of biomarkers is also being discussed, including cerebrospinal fluid proteins, structural and functional brain imaging, and genetic markers. The influence of risk factors, such as diet, exercise and different comorbidities, is emphasised by population-based research, and lifestyle changes are considered for the treatment and prevention of dementia.ConclusionTo improve the diagnosis and management of vascular cognitive impairment, further progress has to be made in understanding the relevant pathomechanisms, including shared mechanisms with Alzheimer’s disease; bringing together fragmented research initiatives in coordinated international programs; testing if known risk factors are modifiable in prospective interventional studies; and defining the pre-dementia and pre-clinical stages in line with the concept of mild cognitive impairment due to Alzheimer’s disease.

【 授权许可】

CC BY   
© The Author(s). 2016