Vascular Cognitive Impairment in Clinical Practice

Transcription

1 Vascular Cognitive Impairment in Clinical Practice

2 Vascular Cognitive Impairment in Clinical Practice Edited by Lars-Olof Wahlund Timo Erkinjuntti Serge Gauthier

3 cambridge university press Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, S~ao Paulo, Delhi Cambridge University Press The Edinburgh Building, Cambridge CB2 8RU, UK Published in the United States of America by Cambridge University Press, New York Information on this title: Ó Cambridge University Press 2009 This publication is in copyright. Subject to statutory exception and to the provisions of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. First published 2009 Printed in the United Kingdom at the University Press, Cambridge A catalog record for this publication is available from the British Library Library of Congress Cataloguing in Publication data Vascular cognitive impairment in clinical practice / [edited by] Lars-Olof Wahlund, Timo Erkinjuntti, Serge Gauthier. p. ; cm. Includes bibliographical references and index. ISBN (hardback) 1. Cerebrovascular disease Complications. 2. Dementia. 3. Cognitive disorders. I. Wahlund, Lars-Olof. II. Erkinjuntti, Timo. III. Gauthier, Serge, 1950 [DNLM: 1. Dementia, Vascular. 2. Cognition Disorders. WM 220 V ] RC388.5.V dc ISBN hardback Cambridge University Press has no responsibility for the persistence or accuracy of URLs for external or third-party internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate. Every effort has been made in preparing this publication to provide accurate and up-to-date information which is in accord with accepted standards and practice at the time of publication. Although case histories are drawn from actual cases, every effort has been made to disguise the identities of the individuals involved. Nevertheless, the authors, editors and publishers can make no warranties that the information contained herein is totally free from error, not least because clinical standards are constantly changing through research and regulation. The authors, editors and publishers therefore disclaim all liability for direct or consequential damages resulting from the use of material contained in this publication. Readers are strongly advised to pay careful attention to information provided by the manufacturer of any drugs or equipment that they plan to use.

4 Contents List of Contributors page vii Preface xi Section 1: Diagnosis 1 1. Diagnosing vascular cognitive impairment and dementia: concepts and controversies 3 Timo Erkinjuntti and Serge Gauthier 2. Vascular cognitive impairment: prodrome to VaD? 11 Adriane Mayda and Charles DeCarli 3. Clinical evaluation: a systematic but user-friendly approach 32 Oscar L. Lopez and David A. Wolk 4. Cognitive functioning in vascular dementia before and after diagnosis 46 Erika J. Laukka, Sari Karlsson, Stuart W.S. MacDonald and Lars Bäckman 5. Structural neuroimaging: CT and MRI 58 Wiesje M. van der Flier, Salka S. Staekenborg, Frederik Barkhof and Philip Scheltens 6. Functional imaging in vascular dementia: clinical practice 70 Lars-Olof Wahlund and Rimma Axelsson 7. Biomarkers in vascular dementia 77 Anders Wallin and Tuula Pirttilä v

5 vi Contents Section 2: Pathophysiology Physiopathology of large-vessel vascular dementia 95 Leonardo Pantoni, Francesca Pescini and Anna Poggesi 9. Small-vessel diseases of the brain 118 Raj N. Kalaria and Timo Erkinjuntti 10. White matter changes 131 Franz Fazekas, Christian Enzinger, Stefan Ropele and Reinhold Schmidt 11. Hereditary forms of cerebrovascular amyloidosis 139 Agueda Rostagno and Jorge Ghiso 12. Role of vascular risk factors in dementia 155 Chengxuan Qiu and Laura Fratiglioni 13. Cardiovascular disease, cognitive decline, and dementia 166 Angela L. Jefferson and Emelia J. Benjamin 14. Vascular factors in Alzheimer s disease: from diagnostic dichotomy to integrative etiology 178 Miia Kivipelto, Alina Solomon and Tiia Ngandu Section 3: Treatment Treatment of cognitive changes 195 Serge Gauthier and Timo Erkinjuntti 16. Treatment of functional decline 200 Lena Borell 17. Treatment of behavioral symptoms in vascular dementia 206 Catherine Cole and Alistair Burns 18. Control of vascular risk factors 220 Deborah Gustafson and Ingmar Skoog Index 235 Color plates are found between pp. 84 and 85.

6 Contributors Rimma Axelsson, MD, PhD CLINTEC, Division of Radiology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden Lars Bäckman, PhD Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden Frederik Barkhof, MD, PhD Professor of Neuroradiology Alzheimer Center and Department of Diagnostic Radiology, VU University Medical Center, Amsterdam, the Netherlands Emelia J. Benjamin, MD, ScM National Heart, Lung and Blood Institute s Framingham Heart Study, Framingham. Department of Preventive Medicine and Whitaker Cardiovascular Institute, School of Medicine, and Department of Epidemiology, School of Public Health, Boston University, Boston, USA Lena Borell, PhD, OT (reg) Professor of Occupational Therapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden Alistair Burns, FRCP, FRCPysch, MD Professor of Old Age Psychiatry, University of Manchester, Wythenshawe Hospital, Manchester, UK vii

7 viii Contributors Catherine Cole, MRCPsych Specialist Registrar in Old Age Psychiatry, University of Manchester, Wythenshawe Hospital, Manchester, UK Charles DeCarli, MD, PhD Professor of Neurology and Director, Alzheimer s Disease Center and Imaging of Dementia and Aging (IDeA) Laboratory, Department of Neurology and Center for Neuroscience, University of California at Davis, Sacramento, USA Christian Enzinger, MD Department of Neurology and Department of Radiology, Division of Neuroradiology, Medical University, Graz, Austria Timo Erkinjuntti, MD, PhD Department of Neurology, University of Helsinki, Helsinki, Finland Franz Fazekas, MD, PhD Department of Neurology, Medical University, Graz, Austria Wiesje M. van der Flier, PhD Assistant Professor, Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands Laura Fratiglioni, MD, PhD Care Sciences and Society, Karolinska Institutet, and Stockholm Gerontology Research Center, Stockholm, Sweden Serge Gauthier, MD, PhD Alzheimer s Disease and Related Disorders Research Unit, McGill Centre for Studies on Aging, Douglas Mental Health University Institute, Montre?al, Que? bec, Canada Deborah Gustafson, MS, PhD Associate Professor, NeuroPsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, Rush University Medical Center, Chicago, USA, Medical College of Wisconsin, Milwankee, USA Angela L. Jefferson, PhD Department of Neurology and Alzheimer s Disease Center, Boston University School of Medicine, Boston, USA Raj N. Kalaria, MD, PhD Wolfson Research Centre, Institute for Ageing and Health, Newcastle General Hospital, Newcastle upon Tyne, UK Sari Karlsson, PhD Care Sciences and Society, Karolinska Institutet, and Department of Clinical Neuroscience, Karolinska Institutet, Karolinska Hospital, Stockholm, Sweden Miia Kivipelto, MD, PhD Caring Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden, and Department of Neuroscience and Neurology, University of Kuopio, Finland Erika J. Laukka, PhD Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden Oscar L. Lopez, MD Departments of Neurology and Psychiatry, Alzheimer s Disease Research Center, University of Pittsburgh School of Medicine, Pittsburgh, USA Jorge Ghiso, PhD Associate Professor, Departments of Pathology and Psychiatry, NYU School of Medicine, New York, USA Stuart W. S. MacDonald, PhD Care Sciences and Society, Karolinska Institutet,

8 Contributors ix Stockholm, Sweden, and Department of Psychology, University of Victoria, Victoria, Canada Adriane Mayda, BS Imaging of Dementia and Aging (IDeA) Laboratory, Center for Neuroscience, University of California at Davis, Sacramento, USA Tiia Ngandu, PhD Caring Sciences and Society (NVS), Karolinska Institutet, Stockholm, Sweden, and Department of Neuroscience and Neurology, University of Kuopio, Finland Leonardo Pantoni, MD, PhD Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy Francesca Pescini, MD Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy Philip Scheltens, MD, PhD Professor of Cognitive Neurology, Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands Reinhold Schmidt, MD, PhD Department of Neurology and Department of Radiology, Division of Neuroradiology, Medical University, Graz, Austria Ingmar Skoog, MD, PhD NeuroPsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Section of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden Alina Solomon Caring Sciences and Society, Karolinska Institutet, Stockholm, Sweden, and Department of Neuroscience and Neurology, University of Kuopio, Finland Tuula Pirttilä, MD, PhD Neurology Unit, Department of Clinical Science, University of Kuopio, Kuopio, Finland Anna Poggesi, MD Department of Neurological and Psychiatric Sciences, University of Florence, Florence, Italy Chengxuan Qiu, PhD Aging Research Center, Department of Neurobiology Care Science and Society, Karolinska Institutet, Stockholm, Sweden Stefan Ropele, PhD Department of Neurology, Medical University, Graz, Austria Agueda Rostagno, PhD Associate Professor, Department of Pathology, NYU School of Medicine, New York, USA Salka S. Staekenborg, MD Alzheimer Center and Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands Lars-Olof Wahlund, MD, PhD Department of Neurobiology Care Science and Society, Section for Clinical Geriatrics, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm Anders Wallin, MD, PhD Section of Psychiatry and Neurochemistry, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden David A. Wolk, MD Assistant Professor, Department of Neurology, University of Pennsylvania, Philadelphia, USA

9 Preface The concepts of vascular cognitive impairment and vascular dementia have recently been discussed assiduously both in the clinical and research worlds. Vascular dementia is regarded as being the second most common dementia disease, second only to Alzheimer s disease. Knowledge of how changes in the blood vessels induce a change in our cognitive capacity and constitute a cause of dementia has increased considerably in recent years. A discussion is underway as to whether changes in the vascular functions of the brain can, to some extent, form the background to neurodegenerative diseases such as Alzheimer s. This thinking is reinforced by the increasing amount of data which suggest that the risk factors we link to cardiovascular diseases are also those linked to Alzheimer s disease. The purpose of this book is, from a broad clinical perspective, to compile the very latest findings within clinical research on vascular dementia and vascular cognitive impairment. This will create a foundation for the implementation of good clinical dementia care. The book is divided into three parts. The first deals with definitions of vascular dementia and the concept of vascular cognitive impairment, diagnostics by reviewing neuropsychological methods, imaging and neurochemical analysis. The second part addresses the underlying histopathological and pathophysiological mechanisms influencing the onset of vascular cognitive impairment as well as the cerebral and cardiovascular risk factors. This also includes a section on genetically influenced vascular conditions. xi

10 xii Preface Finally, a section on treatment from a somewhat broader perspective a review of the pharmacological treatment of cognitive symptoms, the pharmacological treatment and care of secondary symptoms, as well as non-pharmacological measures applied to enhance the daily lives of patients with vascular dementia. Finally, the possibility of primary preventive measures to decrease the risk of falling victim to vascular cognitive impairment is discussed. The book is intended primarily for those interested in, and clinically active specialists within the sphere of dementia, for example, geriatricians, neurologists, internal medics, and the general practitioner. It proposes to present a profound background to what we today regard as being stateof-the-art within the field of vascular dementia, and clinically applicable facts. In this respect, the book also offers a degree of practical application. It is written by some of the world s most prominent researchers within their fields. We would particularly like to thank Anette Eidehall for her excellent editorial contribution during the writing of the book. Drs Maria Kristoffersen Wiberg and Bertil Leidner are specifically acknowledged for providing the MRI and CT images for the cover.