Neuropsychological profiles of vascular disease and risk of dementia: implications for defining vascular cognitive impairment no dementia (VCI-ND)


Change log
Authors
Stephan, BCM 
Soares Cianciarullo Minett, Thais  ORCID logo  https://orcid.org/0000-0002-3232-9455
Muniz-Terrera, G 
Harrison, SL 
Matthews, FE 
Abstract

Background

vascular cognitive impairment no dementia (VCI-ND) defines a preclinical phase of cognitive decline associated with vascular disorders. The neuropsychological profile of VCI-ND may vary according to different vascular conditions.

Objective

to determine the neuropsychological profile of individuals with no dementia and vascular disorders, including hypertension, peripheral vascular disease (PVD), coronary heart disease (CHD), diabetes and stroke. Risk of 2-year incident dementia in individuals with disease and cognitive impairment was also tested.

Methods

participants were from the Cognitive Function and Ageing Study. At baseline, 13,004 individuals aged ≥65 years were enrolled into the study. Individuals were grouped by baseline disorder status (present, absent) for each condition. Cognitive performance was assessed using the Mini Mental State Examination (MMSE) and the Cambridge Cognitive Examination (CAMCOG). Dementia was assessed at 2 years.

Results

in the cross-sectional analysis, hypertension, PVD and CHD were not associated with cognitive impairment. Stroke was associated with impaired global (MMSE) and CAMCOG sub-scale (including memory and non-memory) scores. Diabetes was associated with impairments in global cognitive function (MMSE) and abstract thinking. In the longitudinal analysis, cognitive impairments were associated with incident dementia in all groups.

Conclusion

the neuropsychological profile in individuals with vascular disorders depends on the specific condition investigated. In all conditions cognitive impairment is a risk factor for dementia. A better understanding of which cognitive domains are affected in different disease groups could help improve operationalisation of the neuropsychological criteria for VCI-ND and could also aid with the development of dementia risk prediction models in persons with vascular disease.

Description
Keywords
vascular cognitive impairment no dementia, vascular disease, cognition, dementia risk, epidemiology, older people
Journal Title
Age and Ageing
Conference Name
Journal ISSN
0002-0729
1468-2834
Volume Title
Publisher
Oxford University Press
Sponsorship
Medical Research Council (G0701539)
Medical Research Council (G9901400)
MRC CFAS has been funded by the Medical Research Council (G9901400) and Department of Health.