Acta clinica Croatica, Vol. 45 No. 2, 2006.
Original scientific paper
Early Detection of Mild Cognitive Impairment in Patients with Cerebrovascular Disease
Irena Martinić-Popović
Vesna Šerić
Vida Demarin
Abstract
Evaluation of mild cognitive impairment (MCI) is important because it can enable early medical management in order to prevent severe dementia of Alzheimer's or vascular type. In this pilot study, patients admitted to University Department of Neurology for first ever stroke/transient ischemic attacks (patient group, N=81, mean age 56±7.0 years) and control subjects without signs of cerebrovascular disease (CVD) but with vascular risk factors present (control group, N=45, mean age 53±6.0 years) were tested by use of Mini Mental State Exam (MMSE) and Montreal Cognitive Assessment (MoCA) on admission, and retested at three and six months. In all study subjects standard brain computed tomography, color Doppler flow imaging of carotid arteries with intima-media thickness (IMT) measurement and transcranial Doppler sonography (TCD) were performed. Multiple risk factors were present in 56 (69.1%) patients. Arterial hypertension, hyperlipoproteinemia and diabetes mellitus were most common diagnoses in control subjects. All study subjects had normal initial MMSE, whereas MoCA score was decreased (<26 points) in 52 (57.2%) patients and 23 (9.6%) control subjects. Six months later, the mean MoCA score was 18.87 and mean MMSE 25.25 in patient group. Patients with stroke and multiple risk factors showed a statistically significant cognitive decline in comparison to patients with transient ischemic attacks. At six months, the greatest cognitive decline in patient group was recorded in patients with arterial hypertension and increased IMT. In subjects with cerebrovascular risk factors, early signs of cognitive impairment exist even before the cerebrovascular disease becomes clinically evident. MoCA proved to be an appropriate tool for cognitive evaluation of patients with mild cognitive impairment of vascular type.
Keywords
Brain - pathology; Brain - physiopathology; Cerebrovascular disease - diagnosis; Dementia - Alzheimer disease; Dementia - vascular dementia
Hrčak ID:
14052
URI
Publication date:
1.6.2006.
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