Vascular Factors and Cognitive Dysfunction in Alzheimer Disease

Abstract

BackgroundThe purpose of the present study was to assess the influence of vascular factors on the degree of intensity and rate of progression of cognitive disorders in the course of Alzheimer Disease (AD).Material/MethodsThe research group consisted of 39 persons, all of whom were diagnosed with AD according to the NINCDS/ADRDA criteria. We divided these patients into 2 subgroups, based on the vascular factors measured by the modified Hachinski Ischemic Scale (Ha-mod): group A, without the vascular component (HA-mod score of 0–1 point), and group B, with the vascular component (a score over 1 point). Cognitive functions were evaluated at baseline and again 2 years later, using the Cognitive Part of the Alzheimer Disease Assessment Scale (ADAS-cog).ResultsWe found that the patients from subgroup B, with the stronger vascular component, demonstrated the highest intensity of cognitive disorders at baseline, both in terms of the overall ADAS-cog score, and in the subscores for ideational praxis, orientation, spoken language ability, comprehension of spoken language, and word-finding difficulty in spontaneous speech. Another variable which was connected with the intensity of dementia was age. After 2 years, however, the rate of progression of cognitive disorders was not significantly different between the 2 groups.ConclusionsThe severity of vascular factors correlates directly with the intensity of cognitive disturbances. At the 2-year follow-up examination, however, no correlation was observed in the research group between greater vascular involvement and more rapid progression of cognitive disorders, as measured by the ADAS-cog scale.

Somatic comorbidity and the progression of cognitive impairment

“…The role of lipid metabolism disorders, especially those pertaining to cholesterol metabolism, in dementias have been the subject of many studies (McGuinness et al, 2009;Mushtaq et al, 2014;Baumgart et al, 2015;Pąchalska et al, 2015). Results regarding the role of cholesterol (and, more broadly, lipid metabolism) are often contradictory (McGuinness et al, 2009).…”

“…A decrease in cognitive fitness is associated with the risk of onset of fully symptomatic dementia in a relatively short period of time. This risk is especially serious if the impairment deteriorates, taking the form of mild cognitive impairment (MCI) (Bidzan and Bidzan, 2014;Pąchalska et al, 2015;Bidzan et al, 2017;Cooper et al, 2019). MCI is defined as when cognitive function (usually memory) is impaired, but functionality is preserved (i.e., a person with MCI has no significant impairment in their abilities to perform tasks of daily living), in the absence of medical disturbances.…”

The Experience of Personal Time in Alzheimer’s Disease

“…A healthy person can be confused in time and space in certain situations (after all, most of us experience a temporary sense of confusion in the first moments after waking up from sleep), but it is enough to find the right reference points and we immediately know where we are in time and space. In contrast, the patient with AD due to cognitive deterioration is unable to find such reference points and therefore his consciousness drifts in time and space (Pąchalska, Bidzan L., Bidzan M., & Góral-Półrola, 2015).…”

Towards a Better Diagnosis and Treatment of Dementia: Identifying Common and Distinct Neuropathological Mechanisms in Alzheimer’s Disease and Vascular Dementia

“…B.) Vascular dysfunction and cerebrovascular pathologies may contribute to neurodegeneration in AD [12][13][14], Vascular dysfunction may have a major impact in the pathogenesis of AD [15,16], although the mechanisms of interaction and cause -effects sequences are not fully understood [15]. Vascular pathology is common in elders and increases with advanced age [16].…”