Alzheimer's disease compared with cerebrovascular dementia. Neuropsychological similarities and differences

Villardita, Claudio

doi:10.1111/j.1600-0404.1993.tb05512.x

Cited by 110 publications

(89 citation statements)

References 46 publications

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“…Padovani et al, 1995;Villardita, 1993;Yamashita et al, 1997). This might indicate that the observed group differences are small.…”

Section: Discussionmentioning

confidence: 84%

“…Indeed, performance on memory tasks is hardly assessed by the Wechsler subtests that make up the WAIS. Especially episodic memory functions, as assessed with, for example, story recall, reveal more impairment in AD compared to VaD (Graham et al, 2004;Kertesz & Clydesdale, 1994;Padovani et al, 1995;Villardita, 1993), are not encountered with these Wechsler subtests.…”

Section: Discussionmentioning

confidence: 99%

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Distinguishing between Vascular Dementia and Alzheimer's Disease by Means of the WAIS: A Meta-analysis

Oosterman

Scherder

2006

Journal of Clinical and Experimental Neuropsychology

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“…Padovani et al, 1995;Villardita, 1993;Yamashita et al, 1997). This might indicate that the observed group differences are small.…”

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Distinguishing between Vascular Dementia and Alzheimer's Disease by Means of the WAIS: A Meta-analysis

Oosterman

Scherder

2006

Journal of Clinical and Experimental Neuropsychology

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“…We and others have reviewed this phenomenon in the past; the Table lists a series of suspected and actual vascular risk factors found in AD and also generally in VaD. 9,15,45,96 In addition to sharing vascular risk factors, a major study has reported the coexistence of similar neuropathological features of AD and VaD in elderly nuns. 76 That study also found that these elderly women required an 8-fold increase in neurofibrillary tangles to express the same severity of dementia when strategic cerebral infarctions were absent, suggesting that patients with previous strokes require considerably less AD pathology for dementia symptoms to appear.…”

Section: Ad-vad Correlatesmentioning

confidence: 99%

Alzheimer Disease as a Vascular Disorder

Torre

2002

Stroke

770

491

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Background-The main stumbling block in the clinical management and in the search for a cure of Alzheimer disease (AD) is that the cause of this disorder has remained uncertain until now. Summary of Review-Evidence that sporadic (nongenetic) AD is primarily a vascular rather than a neurodegenerative disorder is reviewed. This conclusion is based on the following evidence: (1) epidemiological studies showing that practically all risk factors for AD reported thus far have a vascular component that reduces cerebral perfusion; (2) risk factor association between AD and vascular dementia (VaD); (3) improvement of cerebral perfusion obtained from most pharmacotherapy used to reduce the symptoms or progression of AD; (4) detection of regional cerebral hypoperfusion with the use of neuroimaging techniques to preclinically identify AD candidates; (5) presence of regional brain microvascular abnormalities before cognitive and neurodegenerative changes; (6) common overlap of clinical AD and VaD cognitive symptoms; (7) similarity of cerebrovascular lesions present in most AD and VaD patients; (8) presence of cerebral hypoperfusion preceding hypometabolism, cognitive decline, and neurodegeneration in AD; and (9) confirmation of the heterogeneous and multifactorial nature of AD, likely resulting from the diverse presence of vascular risk factors or indicators of vascular disease. Conclusions-Since the value of scientific evidence generally revolves around probability and chance, it is concluded that the data presented here pose a powerful argument in support of the proposal that AD should be classified as a vascular disorder. According to elementary statistics, the probability or chance that all these findings are due to an indirect pathological effect or to coincidental circumstances related to the disease process of AD seems highly unlikely. The collective data presented in this review strongly support the concept that sporadic AD is a vascular disorder. It is recommended that current clinical management of patients, treatment targets, research designs, and disease prevention efforts need to be critically reassessed and placed in perspective in light of these important findings. Key Words: Alzheimer disease Ⅲ dementia Ⅲ microcirculation Ⅲ risk factors Ⅲ vascular disorders A lzheimer disease (AD) is an insidious disorder that progressively ravages the brain, destroying its memory, intellect, and dignity in the process. The main stumbling block in the clinical management and in the search for a cure of AD is that the cause of this disorder has remained uncertain until now. For more than 30 years, AD has been classified and managed as a neurodegenerative disorder, 1,2 following a report by Roth in 1955 3 that suggested that dementia should be classified into 2 distinct disorders according to the variable mental changes caused by each: vascular dementia (VaD), caused by vascular lesions, and AD, resulting from a neurodegenerative process.Most investigators in the field have supported Roth's notion that dementing processes will d...

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“…Initially, neuropsychological studies pointed towards patients with VaD performing better on memory tests and worse on tests of executive function compared to patients with AD (Mendez and Ashla-Mendez, 1991;Villardita, 1993). A meta-analysis showed that patients with VaD had greater impairment in frontal executive functioning compared to AD patients but it was accepted that the studies included may have had difficulties with uncertainty in diagnostic criteria for VaD, possible inclusion bias and possible overlap of AD and VaD among other methodological shortcomings (Looi and Sachdev, 1999).…”

Section: Introductionmentioning

confidence: 99%

Executive functioning in Alzheimer's disease and vascular dementia

Barrett

Craig

Lawson

et al. 2009

Int J Geriat Psychiatry

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This is an original work which has not been published elsewhere or submitted for publication elsewhere. A paper on attention deficits in the same cohort of patients has been accepted to JNNP and is currently in print (McGuinness et al.). There is however no overlap between the neuropsychological tests used and it has been referenced in the discussion.Objective: To compare performance of patients with mild-moderate Alzheimer's disease (AD) and vascular dementia (VaD) on tests of executive functioning and working memory. Methods: Patients with AD (n ¼ 76) and VaD (n ¼ 46) were recruited from a memory clinic along with dementia free participants (n ¼ 28). They underwent specific tests of working memory from the Cognitive Drug Research (CDR) battery and pen and paper tests of executive function including CLOX 1 & 2, EXIT25 and a test of verbal fluency (COWAT). All patients had a CT brain scan which was independently scored for white matter change/ischaemia. Results: The AD and VaD groups were significantly impaired on all measures of working memory and executive functioning compared to the disease free group. There were no significant differences between the AD and VaD groups on any measure. Z-scores confirmed the pattern of impairment in executive functioning and working memory was largely equivalent in both patient groups. Small to moderate correlations were seen between the MMSE and the neurocognitive scores in both patient groups and the pattern of correlations was also very similar in both patient groups. Conclusions: This study demonstrates sizeable executive functioning and working memory impairments in patients with mild-moderate AD and VaD but no significant differences between the disease groups.

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Alzheimer's disease compared with cerebrovascular dementia. Neuropsychological similarities and differences

Cited by 110 publications

References 46 publications

Distinguishing between Vascular Dementia and Alzheimer's Disease by Means of the WAIS: A Meta-analysis

Distinguishing between Vascular Dementia and Alzheimer's Disease by Means of the WAIS: A Meta-analysis

Alzheimer Disease as a Vascular Disorder

Executive functioning in Alzheimer's disease and vascular dementia

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