Genetics of Vascular Cognitive Impairment

Leblanc, Gabrielle G.; Meschia, James F.; Stuss, Donald T.; Hachinski, Vladimir

doi:10.1161/01.str.0000195177.61184.49

Cited by 39 publications

(24 citation statements)

References 126 publications

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“…Studies on VCI per se are scarce. As was pointed out in a recent review, 142 genetic determinants of VCI may include both genes implicated in vascular disease conditions that are known to be associated with stroke and cognitive impairment (eg, hypertension and carotid artery disease), and genes that affect the response of the brain to vascular disease (eg, genes impacting ischemic tolerance, neuronal plasticity, etc) Potential strategies for identifying genes of the second class were outlined in that review. The discussion below will focus on more general issues relevant to the search for both classes of genes.…”

Section: Geneticsmentioning

confidence: 99%

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National Institute of Neurological Disorders and Stroke–Canadian Stroke Network Vascular Cognitive Impairment Harmonization Standards

Hachinski

Iadecola

Petersen

et al. 2006

Stroke

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1,489

1,292

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Background and Purpose-One in 3 individuals will experience a stroke, dementia or both. Moreover, twice as many individuals will have cognitive impairment short of dementia as either stroke or dementia. The commonly used stroke scales do not measure cognition, while dementia criteria focus on the late stages of cognitive impairment, and are heavily biased toward the diagnosis of Alzheimer disease. No commonly agreed standards exist for identifying and describing individuals with cognitive impairment, particularly in the early stages, and especially with cognitive impairment related to vascular factors, or vascular cognitive impairment. Methods-The National Institute for Neurological Disorders and Stroke (NINDS) and the Canadian Stroke Network (CSN) convened researchers in clinical diagnosis, epidemiology, neuropsychology, brain imaging, neuropathology, experimental models, biomarkers, genetics, and clinical trials to recommend minimum, common, clinical and research standards for the description and study of vascular cognitive impairment. Results-The results of these discussions are reported herein. Conclusions-The development of common standards represents a first step in a process of use, validation and refinement. Using the same standards will help identify individuals in the early stages of cognitive impairment, will make studies comparable, and by integrating knowledge, will accelerate the pace of progress.

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Section: Geneticsmentioning

confidence: 99%

“…The general principles underlying these approaches and the methodological issues surrounding association studies in stroke have been covered by recent reviews. [142][143][144] Studies on genetic risk factors for VCI face specific challenges. Key issues include:…”

Section: Genetic Risk Factors For Vcimentioning

confidence: 99%

National Institute of Neurological Disorders and Stroke–Canadian Stroke Network Vascular Cognitive Impairment Harmonization Standards

Hachinski

Iadecola

Petersen

et al. 2006

Stroke

Self Cite

1,489

1,292

View full text Add to dashboard Cite

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“…Vascular factors contribute significantly to the onset and progression of dementia with 15-34% of patients with dementia demonstrating vascular pathology [1,2]. Most patients diagnosed with vascular dementia have mixed Alzheimer's and vascular pathology and it is often difficult to disentangle the respective contributions of these two pathologies to the cognitive and clinical outcomes [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Frontal subcortical ischemia is crucial for post stroke cognitive impairment

Kandiah

Wiryasaputra

Narasimhalu

et al. 2011

Journal of the Neurological Sciences

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“…CVD-associated cognitive impairments often impact everyday functional abilities [3,4,5], even when the impairments are not so severe as to incur a diagnosis of dementia [6,7]. Indeed, an emerging consensus in the field proposes that cognitive impairment attributable to vascular disorders should be viewed along a continuum, ranging from minimal cognitive difficulties (i.e.…”

Section: Introductionmentioning

confidence: 99%

Longitudinal Trajectories of Cognitive Decline among Older Adults with Cardiovascular Disease

Okonkwo

Cohen²,

Gunstad

et al. 2010

Cerebrovasc Dis

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Background: The long-term course of cognitive impairments secondary to cardiovascular disease (CVD) is unclear. In this study, we prospectively investigated the temporal pattern, rate and hierarchy of cognitive decline attributable to CVD – a risk factor for the development of vascular cognitive impairment (VCI) – and examined the influence of cardiac surgery and heart failure on cognitive decline. Methods: A total of 172 older adults with CVD were administered a comprehensive battery of neuropsychological tests at study entry, and at 12 and 36 months thereafter. Random coefficient regressions were used to investigate the temporal course, rate and hierarchy of cognitive decline, as well as to examine the effect of heart failure (reported by 21% of the sample) and cardiac surgery (reported by 44% of the sample) on trajectories of cognitive change. Results: The course of decline in cognition was linear for language and attention-executive function-psychomotor speed, and curvilinear for visuospatial abilities, memory and overall cognition. The decline in attention-executive function-psychomotor speed was smaller than the decline in other domains. The greatest decline occurred in visuospatial abilities. The rate of decline in cognition was not altered by a history of heart failure. Patients who had undergone cardiac surgery exhibited slower deceleration in their rates of decline in overall cognition. At baseline, patients with a history of heart failure had comparatively poorer attention-executive function-psychomotor speed, overall cognition and, to a lesser extent, visuospatial scores. Conclusion: There is measurable decline in neurocognitive function among patients with CVD. This decline is linear in some cognitive domains and curvilinear in others and is not attributable to the normal aging process. Cardiac surgery, but not heart failure, significantly affects the trajectory of cognitive decline. Because most vascular risk factors are modifiable, preventive measures such as lifestyle changes may be useful in retarding cognitive decline among patients with CVD, thus preventing the onset of VCI.

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Genetics of Vascular Cognitive Impairment

Abstract: The most critical challenge for genetic studies of VCI is to identify quantifiable phenotypes that can be reliably and effectively determined in large samples of subjects.

Cited by 39 publications

References 126 publications

National Institute of Neurological Disorders and Stroke–Canadian Stroke Network Vascular Cognitive Impairment Harmonization Standards

National Institute of Neurological Disorders and Stroke–Canadian Stroke Network Vascular Cognitive Impairment Harmonization Standards

Frontal subcortical ischemia is crucial for post stroke cognitive impairment

Longitudinal Trajectories of Cognitive Decline among Older Adults with Cardiovascular Disease

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