Vascular cognitive disorder: a new diagnostic category updating vascular cognitive impairment and vascular dementia
Identifieur interne : 004B86 ( PascalFrancis/Corpus ); précédent : 004B85; suivant : 004B87Vascular cognitive disorder: a new diagnostic category updating vascular cognitive impairment and vascular dementia
Auteurs : Gustavo C. Roman ; Perminder Sachdev ; Donald R. Royall ; Roger A. Bullock ; Jean-Marc Orgogozo ; Secundino Lopez-Pousa ; Raul Arizaga ; Anders WallinSource :
- Journal of the neurological sciences [ 0022-510X ] ; 2004.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
Abstract
Vascular cognitive impairment (VCI) was proposed as an umbrella term to include subjects affected with any degree of cognitive impairment resulting from cerebrovascular disease (CVD), ranging from mild cognitive impairment (MCI) to vascular dementia. VCI may or may not exclude the host of "focal" circumscribed impairments of specialized functions such as language (aphasia), intentional gesture (apraxia), or categorical recognition (agnosia), among others, that may result from a stroke. Therefore, there are no universally accepted diagnostic criteria for VCI. We conclude that this concept could be more useful if it were to be limited to cases of vascular MCI without dementia, by analogy with the concept of amnestic MCI, currently considered the earliest clinically diagnosable stage of Alzheimer disease (AD). In agreement with our view, the Canadian Study on Health and Aging successfully implemented a restricted definition of VCI, excluding cases of dementia (i.e., vascular cognitive impairment no dementia, VCI-ND). The Canadian definition and diagnostic criteria could be utilized for future studies of VCI. This definition excludes isolated impairments of specialized cognitive functions. Vascular dementia (VaD): The main problem of this diagnostic category stems from the currently accepted definition of dementia that requires memory loss as the sine qua non for the diagnosis. This may result in over-sampling of patients with AD worsened by stroke (AD+CVD). This problem was minimized in controlled clinical trials of VaD by excluding patients with a prior diagnosis of AD, those with pre-existing memory loss before the index stroke, and those with amnestic MCI. We propose a definition of dementia in VaD based on presence of abnormal executive control function, severe enough to interfere with social or occupational functioning. Vascular cognitive disorder (VCD): This term, proposed by Sachdev [P. Sachdev, Vascular cognitive disorder. Int J Geriat Psychiatry 14 (1999) 402-403. would become the global diagnostic category for cognitive impairment of vascular origin, ranging from VCI to VaD. It would include specific disease entities such as post-stroke VCI, post-stroke VaD, CADASIL, Binswanger disease, and AD plus CVD. This category explicitly excludes isolated cognitive dysfunctions such as those mentioned above.
Notice en format standard (ISO 2709)
Pour connaître la documentation sur le format Inist Standard.
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Format Inist (serveur)
NO : | PASCAL 05-0011784 INIST |
---|---|
ET : | Vascular cognitive disorder: a new diagnostic category updating vascular cognitive impairment and vascular dementia |
AU : | ROMAN (Gustavo C.); SACHDEV (Perminder); ROYALL (Donald R.); BULLOCK (Roger A.); ORGOGOZO (Jean-Marc); LOPEZ-POUSA (Secundino); ARIZAGA (Raul); WALLIN (Anders); ROMAN (Gustavo C.); WALLIN (Anders); SKOOG (Ingmar); KALARIA (Raj N.) |
AF : | Department of Medicine/Neurology, University of Texas HSC at San Antonio and the Audie Murphy Veterans Administration Hospital, Mail Code 7883, 7703 Floyd Curl Drive/San Antonio, TX 78229-3900/Etats-Unis (1 aut.); School of Psychiatry, University of New South Wales: Neuropsychiatric Institute, the Prince of Wales Hospital/Sydney/Australie (2 aut.); Departments of Psychiatry, Medicine, and Pharmacology, University of Texas HSC at San Antonio and the Audio Murphy Veterans Administration Hospital/San Antonio, TX/Etats-Unis (3 aut.); Kingshill Research Centre, Victoria Hospital/Swindon/Royaume-Uni (4 aut.); CHU Pellegrin/Bordeaux/France (5 aut.); Memory and Dementia Unit, Hospital Santa Caterina/Girona/Espagne (6 aut.); Memory Disorders Research Center and Neuroepidemiology Branch, National Institute of Social Services for Retirees/Buenos Aires/Argentine (7 aut.); Institute of Clinical Neuroscience, Sahlgrenska University Hospital/Molndal/Suède (8 aut.); Department of Medicine, Division of Neurology, University of Texas, Health Science Center at San Antonio, Mail Code 7883, 7703 Floyd Curl Drive/San Antonio, TX 78229-3900/Etats-Unis (1 aut.); Institute of Clinical Neuroscience, Sahlgrenska University Hospital/43180 Mölndal/Suède (2 aut., 3 aut.); Institute for Ageing and Health, Wolfson Centre, Newcastle General Hospital, Westgate Road/Newcastle upon Tyne NE4 6BE/Royaume-Uni (4 aut.) |
DT : | Publication en série; Congrès; Niveau analytique |
SO : | Journal of the neurological sciences; ISSN 0022-510X; Coden JNSCAG; Irlande; Da. 2004; Vol. 226; No. 1-2; Pp. 81-87; Bibl. 50 ref. |
LA : | Anglais |
EA : | Vascular cognitive impairment (VCI) was proposed as an umbrella term to include subjects affected with any degree of cognitive impairment resulting from cerebrovascular disease (CVD), ranging from mild cognitive impairment (MCI) to vascular dementia. VCI may or may not exclude the host of "focal" circumscribed impairments of specialized functions such as language (aphasia), intentional gesture (apraxia), or categorical recognition (agnosia), among others, that may result from a stroke. Therefore, there are no universally accepted diagnostic criteria for VCI. We conclude that this concept could be more useful if it were to be limited to cases of vascular MCI without dementia, by analogy with the concept of amnestic MCI, currently considered the earliest clinically diagnosable stage of Alzheimer disease (AD). In agreement with our view, the Canadian Study on Health and Aging successfully implemented a restricted definition of VCI, excluding cases of dementia (i.e., vascular cognitive impairment no dementia, VCI-ND). The Canadian definition and diagnostic criteria could be utilized for future studies of VCI. This definition excludes isolated impairments of specialized cognitive functions. Vascular dementia (VaD): The main problem of this diagnostic category stems from the currently accepted definition of dementia that requires memory loss as the sine qua non for the diagnosis. This may result in over-sampling of patients with AD worsened by stroke (AD+CVD). This problem was minimized in controlled clinical trials of VaD by excluding patients with a prior diagnosis of AD, those with pre-existing memory loss before the index stroke, and those with amnestic MCI. We propose a definition of dementia in VaD based on presence of abnormal executive control function, severe enough to interfere with social or occupational functioning. Vascular cognitive disorder (VCD): This term, proposed by Sachdev [P. Sachdev, Vascular cognitive disorder. Int J Geriat Psychiatry 14 (1999) 402-403. would become the global diagnostic category for cognitive impairment of vascular origin, ranging from VCI to VaD. It would include specific disease entities such as post-stroke VCI, post-stroke VaD, CADASIL, Binswanger disease, and AD plus CVD. This category explicitly excludes isolated cognitive dysfunctions such as those mentioned above. |
CC : | 002B17; 002B17C; 002B17A02 |
FD : | Système nerveux pathologie; Diagnostic; Mise à jour; Trouble cognition; Sénescence; Cognition; Démence vasculaire; Cérébrovasculaire pathologie |
FG : | Système nerveux central pathologie; Encéphale pathologie |
ED : | Nervous system diseases; Diagnosis; Updating; Cognitive disorder; Senescence; Cognition; Vascular dementia; Cerebrovascular disease |
EG : | Central nervous system disease; Cerebral disorder |
SD : | Sistema nervioso patología; Diagnóstico; Actualización; Trastorno cognitivo; Senescencia; Cognición; Demencia vascular; Vaso sanguíneo encéfalo patología |
LO : | INIST-12185.354000122640170170 |
ID : | 05-0011784 |
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<front><div type="abstract" xml:lang="en">Vascular cognitive impairment (VCI) was proposed as an umbrella term to include subjects affected with any degree of cognitive impairment resulting from cerebrovascular disease (CVD), ranging from mild cognitive impairment (MCI) to vascular dementia. VCI may or may not exclude the host of "focal" circumscribed impairments of specialized functions such as language (aphasia), intentional gesture (apraxia), or categorical recognition (agnosia), among others, that may result from a stroke. Therefore, there are no universally accepted diagnostic criteria for VCI. We conclude that this concept could be more useful if it were to be limited to cases of vascular MCI without dementia, by analogy with the concept of amnestic MCI, currently considered the earliest clinically diagnosable stage of Alzheimer disease (AD). In agreement with our view, the Canadian Study on Health and Aging successfully implemented a restricted definition of VCI, excluding cases of dementia (i.e., vascular cognitive impairment no dementia, VCI-ND). The Canadian definition and diagnostic criteria could be utilized for future studies of VCI. This definition excludes isolated impairments of specialized cognitive functions. Vascular dementia (VaD): The main problem of this diagnostic category stems from the currently accepted definition of dementia that requires memory loss as the sine qua non for the diagnosis. This may result in over-sampling of patients with AD worsened by stroke (AD+CVD). This problem was minimized in controlled clinical trials of VaD by excluding patients with a prior diagnosis of AD, those with pre-existing memory loss before the index stroke, and those with amnestic MCI. We propose a definition of dementia in VaD based on presence of abnormal executive control function, severe enough to interfere with social or occupational functioning. Vascular cognitive disorder (VCD): This term, proposed by Sachdev [P. Sachdev, Vascular cognitive disorder. Int J Geriat Psychiatry 14 (1999) 402-403. would become the global diagnostic category for cognitive impairment of vascular origin, ranging from VCI to VaD. It would include specific disease entities such as post-stroke VCI, post-stroke VaD, CADASIL, Binswanger disease, and AD plus CVD. This category explicitly excludes isolated cognitive dysfunctions such as those mentioned above.</div>
</front>
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<inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0022-510X</s0>
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<fA02 i1="01"><s0>JNSCAG</s0>
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<fA03 i2="1"><s0>J. neurol. sci.</s0>
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<fA08 i1="01" i2="1" l="ENG"><s1>Vascular cognitive disorder: a new diagnostic category updating vascular cognitive impairment and vascular dementia</s1>
</fA08>
<fA09 i1="01" i2="1" l="ENG"><s1>Proceedings of the First Congress of the International Society for Vascular Behavioural and Cognitive Disorders (VAS-COG 2003)</s1>
</fA09>
<fA11 i1="01" i2="1"><s1>ROMAN (Gustavo C.)</s1>
</fA11>
<fA11 i1="02" i2="1"><s1>SACHDEV (Perminder)</s1>
</fA11>
<fA11 i1="03" i2="1"><s1>ROYALL (Donald R.)</s1>
</fA11>
<fA11 i1="04" i2="1"><s1>BULLOCK (Roger A.)</s1>
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<fA11 i1="05" i2="1"><s1>ORGOGOZO (Jean-Marc)</s1>
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<fA11 i1="06" i2="1"><s1>LOPEZ-POUSA (Secundino)</s1>
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<fA11 i1="07" i2="1"><s1>ARIZAGA (Raul)</s1>
</fA11>
<fA11 i1="08" i2="1"><s1>WALLIN (Anders)</s1>
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<fA12 i1="01" i2="1"><s1>ROMAN (Gustavo C.)</s1>
<s9>ed.</s9>
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<fA12 i1="02" i2="1"><s1>WALLIN (Anders)</s1>
<s9>ed.</s9>
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<fA12 i1="03" i2="1"><s1>SKOOG (Ingmar)</s1>
<s9>ed.</s9>
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<fA12 i1="04" i2="1"><s1>KALARIA (Raj N.)</s1>
<s9>ed.</s9>
</fA12>
<fA14 i1="01"><s1>Department of Medicine/Neurology, University of Texas HSC at San Antonio and the Audie Murphy Veterans Administration Hospital, Mail Code 7883, 7703 Floyd Curl Drive</s1>
<s2>San Antonio, TX 78229-3900</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
</fA14>
<fA14 i1="02"><s1>School of Psychiatry, University of New South Wales: Neuropsychiatric Institute, the Prince of Wales Hospital</s1>
<s2>Sydney</s2>
<s3>AUS</s3>
<sZ>2 aut.</sZ>
</fA14>
<fA14 i1="03"><s1>Departments of Psychiatry, Medicine, and Pharmacology, University of Texas HSC at San Antonio and the Audio Murphy Veterans Administration Hospital</s1>
<s2>San Antonio, TX</s2>
<s3>USA</s3>
<sZ>3 aut.</sZ>
</fA14>
<fA14 i1="04"><s1>Kingshill Research Centre, Victoria Hospital</s1>
<s2>Swindon</s2>
<s3>GBR</s3>
<sZ>4 aut.</sZ>
</fA14>
<fA14 i1="05"><s1>CHU Pellegrin</s1>
<s2>Bordeaux</s2>
<s3>FRA</s3>
<sZ>5 aut.</sZ>
</fA14>
<fA14 i1="06"><s1>Memory and Dementia Unit, Hospital Santa Caterina</s1>
<s2>Girona</s2>
<s3>ESP</s3>
<sZ>6 aut.</sZ>
</fA14>
<fA14 i1="07"><s1>Memory Disorders Research Center and Neuroepidemiology Branch, National Institute of Social Services for Retirees</s1>
<s2>Buenos Aires</s2>
<s3>ARG</s3>
<sZ>7 aut.</sZ>
</fA14>
<fA14 i1="08"><s1>Institute of Clinical Neuroscience, Sahlgrenska University Hospital</s1>
<s2>Molndal</s2>
<s3>SWE</s3>
<sZ>8 aut.</sZ>
</fA14>
<fA15 i1="01"><s1>Department of Medicine, Division of Neurology, University of Texas, Health Science Center at San Antonio, Mail Code 7883, 7703 Floyd Curl Drive</s1>
<s2>San Antonio, TX 78229-3900</s2>
<s3>USA</s3>
<sZ>1 aut.</sZ>
</fA15>
<fA15 i1="02"><s1>Institute of Clinical Neuroscience, Sahlgrenska University Hospital</s1>
<s2>43180 Mölndal</s2>
<s3>SWE</s3>
<sZ>2 aut.</sZ>
<sZ>3 aut.</sZ>
</fA15>
<fA15 i1="03"><s1>Institute for Ageing and Health, Wolfson Centre, Newcastle General Hospital, Westgate Road</s1>
<s2>Newcastle upon Tyne NE4 6BE</s2>
<s3>GBR</s3>
<sZ>4 aut.</sZ>
</fA15>
<fA18 i1="01" i2="1"><s1>International Society for Vascular Behavioural and Cognitive Disorders</s1>
<s3>INT</s3>
<s9>patr.</s9>
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<fA20><s1>81-87</s1>
</fA20>
<fA21><s1>2004</s1>
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<fA44><s0>0000</s0>
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</fA44>
<fA45><s0>50 ref.</s0>
</fA45>
<fA47 i1="01" i2="1"><s0>05-0011784</s0>
</fA47>
<fA60><s1>P</s1>
<s2>C</s2>
</fA60>
<fA61><s0>A</s0>
</fA61>
<fA64 i1="01" i2="1"><s0>Journal of the neurological sciences</s0>
</fA64>
<fA66 i1="01"><s0>IRL</s0>
</fA66>
<fC01 i1="01" l="ENG"><s0>Vascular cognitive impairment (VCI) was proposed as an umbrella term to include subjects affected with any degree of cognitive impairment resulting from cerebrovascular disease (CVD), ranging from mild cognitive impairment (MCI) to vascular dementia. VCI may or may not exclude the host of "focal" circumscribed impairments of specialized functions such as language (aphasia), intentional gesture (apraxia), or categorical recognition (agnosia), among others, that may result from a stroke. Therefore, there are no universally accepted diagnostic criteria for VCI. We conclude that this concept could be more useful if it were to be limited to cases of vascular MCI without dementia, by analogy with the concept of amnestic MCI, currently considered the earliest clinically diagnosable stage of Alzheimer disease (AD). In agreement with our view, the Canadian Study on Health and Aging successfully implemented a restricted definition of VCI, excluding cases of dementia (i.e., vascular cognitive impairment no dementia, VCI-ND). The Canadian definition and diagnostic criteria could be utilized for future studies of VCI. This definition excludes isolated impairments of specialized cognitive functions. Vascular dementia (VaD): The main problem of this diagnostic category stems from the currently accepted definition of dementia that requires memory loss as the sine qua non for the diagnosis. This may result in over-sampling of patients with AD worsened by stroke (AD+CVD). This problem was minimized in controlled clinical trials of VaD by excluding patients with a prior diagnosis of AD, those with pre-existing memory loss before the index stroke, and those with amnestic MCI. We propose a definition of dementia in VaD based on presence of abnormal executive control function, severe enough to interfere with social or occupational functioning. Vascular cognitive disorder (VCD): This term, proposed by Sachdev [P. Sachdev, Vascular cognitive disorder. Int J Geriat Psychiatry 14 (1999) 402-403. would become the global diagnostic category for cognitive impairment of vascular origin, ranging from VCI to VaD. It would include specific disease entities such as post-stroke VCI, post-stroke VaD, CADASIL, Binswanger disease, and AD plus CVD. This category explicitly excludes isolated cognitive dysfunctions such as those mentioned above.</s0>
</fC01>
<fC02 i1="01" i2="X"><s0>002B17</s0>
</fC02>
<fC02 i1="02" i2="X"><s0>002B17C</s0>
</fC02>
<fC02 i1="03" i2="X"><s0>002B17A02</s0>
</fC02>
<fC03 i1="01" i2="X" l="FRE"><s0>Système nerveux pathologie</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="ENG"><s0>Nervous system diseases</s0>
<s5>01</s5>
</fC03>
<fC03 i1="01" i2="X" l="SPA"><s0>Sistema nervioso patología</s0>
<s5>01</s5>
</fC03>
<fC03 i1="02" i2="X" l="FRE"><s0>Diagnostic</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="ENG"><s0>Diagnosis</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="SPA"><s0>Diagnóstico</s0>
<s5>02</s5>
</fC03>
<fC03 i1="03" i2="X" l="FRE"><s0>Mise à jour</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="ENG"><s0>Updating</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="SPA"><s0>Actualización</s0>
<s5>03</s5>
</fC03>
<fC03 i1="04" i2="X" l="FRE"><s0>Trouble cognition</s0>
<s5>04</s5>
</fC03>
<fC03 i1="04" i2="X" l="ENG"><s0>Cognitive disorder</s0>
<s5>04</s5>
</fC03>
<fC03 i1="04" i2="X" l="SPA"><s0>Trastorno cognitivo</s0>
<s5>04</s5>
</fC03>
<fC03 i1="05" i2="X" l="FRE"><s0>Sénescence</s0>
<s5>05</s5>
</fC03>
<fC03 i1="05" i2="X" l="ENG"><s0>Senescence</s0>
<s5>05</s5>
</fC03>
<fC03 i1="05" i2="X" l="SPA"><s0>Senescencia</s0>
<s5>05</s5>
</fC03>
<fC03 i1="06" i2="X" l="FRE"><s0>Cognition</s0>
<s5>06</s5>
</fC03>
<fC03 i1="06" i2="X" l="ENG"><s0>Cognition</s0>
<s5>06</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA"><s0>Cognición</s0>
<s5>06</s5>
</fC03>
<fC03 i1="07" i2="X" l="FRE"><s0>Démence vasculaire</s0>
<s2>NM</s2>
<s5>07</s5>
</fC03>
<fC03 i1="07" i2="X" l="ENG"><s0>Vascular dementia</s0>
<s2>NM</s2>
<s5>07</s5>
</fC03>
<fC03 i1="07" i2="X" l="SPA"><s0>Demencia vascular</s0>
<s2>NM</s2>
<s5>07</s5>
</fC03>
<fC03 i1="08" i2="X" l="FRE"><s0>Cérébrovasculaire pathologie</s0>
<s5>10</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG"><s0>Cerebrovascular disease</s0>
<s5>10</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA"><s0>Vaso sanguíneo encéfalo patología</s0>
<s5>10</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE"><s0>Système nerveux central pathologie</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="ENG"><s0>Central nervous system disease</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="FRE"><s0>Encéphale pathologie</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="ENG"><s0>Cerebral disorder</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="SPA"><s0>Encéfalo patología</s0>
<s5>38</s5>
</fC07>
<fN21><s1>004</s1>
</fN21>
<fN44 i1="01"><s1>OTO</s1>
</fN44>
<fN82><s1>OTO</s1>
</fN82>
</pA>
<pR><fA30 i1="01" i2="1" l="ENG"><s1>VAS-COG 2003 Congress of the International Society for Vascular Behavioural and Cognitive Disorders</s1>
<s2>1</s2>
<s3>Göteborg SWE</s3>
<s4>2003-08-28</s4>
</fA30>
</pR>
</standard>
<server><NO>PASCAL 05-0011784 INIST</NO>
<ET>Vascular cognitive disorder: a new diagnostic category updating vascular cognitive impairment and vascular dementia</ET>
<AU>ROMAN (Gustavo C.); SACHDEV (Perminder); ROYALL (Donald R.); BULLOCK (Roger A.); ORGOGOZO (Jean-Marc); LOPEZ-POUSA (Secundino); ARIZAGA (Raul); WALLIN (Anders); ROMAN (Gustavo C.); WALLIN (Anders); SKOOG (Ingmar); KALARIA (Raj N.)</AU>
<AF>Department of Medicine/Neurology, University of Texas HSC at San Antonio and the Audie Murphy Veterans Administration Hospital, Mail Code 7883, 7703 Floyd Curl Drive/San Antonio, TX 78229-3900/Etats-Unis (1 aut.); School of Psychiatry, University of New South Wales: Neuropsychiatric Institute, the Prince of Wales Hospital/Sydney/Australie (2 aut.); Departments of Psychiatry, Medicine, and Pharmacology, University of Texas HSC at San Antonio and the Audio Murphy Veterans Administration Hospital/San Antonio, TX/Etats-Unis (3 aut.); Kingshill Research Centre, Victoria Hospital/Swindon/Royaume-Uni (4 aut.); CHU Pellegrin/Bordeaux/France (5 aut.); Memory and Dementia Unit, Hospital Santa Caterina/Girona/Espagne (6 aut.); Memory Disorders Research Center and Neuroepidemiology Branch, National Institute of Social Services for Retirees/Buenos Aires/Argentine (7 aut.); Institute of Clinical Neuroscience, Sahlgrenska University Hospital/Molndal/Suède (8 aut.); Department of Medicine, Division of Neurology, University of Texas, Health Science Center at San Antonio, Mail Code 7883, 7703 Floyd Curl Drive/San Antonio, TX 78229-3900/Etats-Unis (1 aut.); Institute of Clinical Neuroscience, Sahlgrenska University Hospital/43180 Mölndal/Suède (2 aut., 3 aut.); Institute for Ageing and Health, Wolfson Centre, Newcastle General Hospital, Westgate Road/Newcastle upon Tyne NE4 6BE/Royaume-Uni (4 aut.)</AF>
<DT>Publication en série; Congrès; Niveau analytique</DT>
<SO>Journal of the neurological sciences; ISSN 0022-510X; Coden JNSCAG; Irlande; Da. 2004; Vol. 226; No. 1-2; Pp. 81-87; Bibl. 50 ref.</SO>
<LA>Anglais</LA>
<EA>Vascular cognitive impairment (VCI) was proposed as an umbrella term to include subjects affected with any degree of cognitive impairment resulting from cerebrovascular disease (CVD), ranging from mild cognitive impairment (MCI) to vascular dementia. VCI may or may not exclude the host of "focal" circumscribed impairments of specialized functions such as language (aphasia), intentional gesture (apraxia), or categorical recognition (agnosia), among others, that may result from a stroke. Therefore, there are no universally accepted diagnostic criteria for VCI. We conclude that this concept could be more useful if it were to be limited to cases of vascular MCI without dementia, by analogy with the concept of amnestic MCI, currently considered the earliest clinically diagnosable stage of Alzheimer disease (AD). In agreement with our view, the Canadian Study on Health and Aging successfully implemented a restricted definition of VCI, excluding cases of dementia (i.e., vascular cognitive impairment no dementia, VCI-ND). The Canadian definition and diagnostic criteria could be utilized for future studies of VCI. This definition excludes isolated impairments of specialized cognitive functions. Vascular dementia (VaD): The main problem of this diagnostic category stems from the currently accepted definition of dementia that requires memory loss as the sine qua non for the diagnosis. This may result in over-sampling of patients with AD worsened by stroke (AD+CVD). This problem was minimized in controlled clinical trials of VaD by excluding patients with a prior diagnosis of AD, those with pre-existing memory loss before the index stroke, and those with amnestic MCI. We propose a definition of dementia in VaD based on presence of abnormal executive control function, severe enough to interfere with social or occupational functioning. Vascular cognitive disorder (VCD): This term, proposed by Sachdev [P. Sachdev, Vascular cognitive disorder. Int J Geriat Psychiatry 14 (1999) 402-403. would become the global diagnostic category for cognitive impairment of vascular origin, ranging from VCI to VaD. It would include specific disease entities such as post-stroke VCI, post-stroke VaD, CADASIL, Binswanger disease, and AD plus CVD. This category explicitly excludes isolated cognitive dysfunctions such as those mentioned above.</EA>
<CC>002B17; 002B17C; 002B17A02</CC>
<FD>Système nerveux pathologie; Diagnostic; Mise à jour; Trouble cognition; Sénescence; Cognition; Démence vasculaire; Cérébrovasculaire pathologie</FD>
<FG>Système nerveux central pathologie; Encéphale pathologie</FG>
<ED>Nervous system diseases; Diagnosis; Updating; Cognitive disorder; Senescence; Cognition; Vascular dementia; Cerebrovascular disease</ED>
<EG>Central nervous system disease; Cerebral disorder</EG>
<SD>Sistema nervioso patología; Diagnóstico; Actualización; Trastorno cognitivo; Senescencia; Cognición; Demencia vascular; Vaso sanguíneo encéfalo patología</SD>
<LO>INIST-12185.354000122640170170</LO>
<ID>05-0011784</ID>
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