Vascular Cognitive Impairment in Clinical Practice »

Lars-Olof Wahund is a Professor at the Department of Neurobiology, Caring Sciences and Society at the Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden.

Timo Erkinjuntti is Professor of Neurology at the Department of Neurology, University of Helsinki, Helsinki, Finland.

Serge Gauthier is a Professor and Director at the Alzheimer's Disease and Related Disorders Research Unit, McGill Centre for Studies on Aging, Douglas Mental Health University Institute, Montréal, Québec, Canada.

Gives a broad clinical perspective on vascular cognitive impairment, and creates a foundation for the implementation of good dementia care.

Doody Review Services

Reviewer:David O. Staats, MD(University of Oklahoma Health Sciences Center)
Description:This multiauthored monograph chronicles how changes in brain blood vessels affect cognition and cause dementia and other related syndromes. It is a brilliant synthesis of a complicated topic, drawing together knowledge and recent discoveries from a wide variety of disciplines.
Purpose:The purpose is to review the knowledge of vascular cognitive impairment and provide practical suggestions for evaluation and treatment of these conditions. Because vascular dementia is the second leading cause of dementia, this book is urgently needed. The authors accomplish their objectives handsomely.
Audience:The audience includes neurologists, gerontologists, geriatricians, and other physicians who evaluate and care for demented persons.
Features:The 18 chapters are divided among three sections: diagnosis, pathophysiology, and treatment. Excellently reproduced imaging studies and histopathology slides enhance all of these sections. The sections link together what is known about how the brain processes information in neural networks (how the brain works) with how vascular abnormalities interrupt these processes (how diseases work). This, in turn, leads to diagnostic methods and treatments.
Assessment:This is a major contribution to the field. It sorts out in clear fashion a very tangled literature. In the process, it points out just where future research is needed. Methodological issues of such research and the profound implications of epidemiological studies (vascular disease starts early and causes cognitive changes in midlife) are emphasized. In addition, the book provides clear outlines of the approach to differential diagnosis and management of these patients, including caregiver support. Finally, the links of heart disease to both vascular cognitive impairment and Alzheimer's disease are discussed. The excellent organization and editing of this book, its careful elaboration of complex concepts, and the practical application of this synthesis give rise to a first-rate work. This much-needed book deserves a wide readership.

List of Contributors vii

Preface xi

Section 1 Diagnosis 1

1 Diagnosing vascular cognitive impairment and dementia: concepts and controversies Timo Erkinjuntti Serge Gauthier 3

2 Vascular cognitive impairment: prodrome to VaD? Adriane Mayda Charles DeCarli 11

3 Clinical evaluation: a systematic but user-friendly approach Oscar L. Lopez David A. Wolk 32

4 Cognitive functioning in vascular dementia before and after diagnosis Erika J. Laukka Sari Karlsson Stuart W.S. MacDonald Lars Backman 46

5 Structural neuroimaging: CT and MRI Wiesje M. van der Flier Salka S. Staekenborg Frederik Barkhof Philip Scheltens 58

6 Functional imaging in vascular dementia: clinical practice Lars-Olof Wahlund Rimma Axelsson 70

7 Biomarkers in vascular dementia Anders Wallin Tuula Pirttila 77

Section 2 Pathophysiology 93

8 Physiopathology of large-vessel vascular dementia Leonardo Pantoni Francesca Pescini Anna Poggesi 95

9 Small-vessel diseases of the brain Raj N. Kalaria Timo Erkinjuntti 118

10 White matter changes Franz Fazekas Christian Enzinger Stefan Ropele Reinhold Schmidt 131

11 Hereditary forms of cerebrovascular amyloidosis Agueda Rostagno Jorge Ghiso 139

12 Role of vascular risk factors in dementia Chengxuan Qiu Laura Fratiglioni 155

13 Cardiovascular disease, cognitive decline, and dementia Angela L. Jefferson Emelia J. Benjamin 166

14 Vascular factors in Alzheimer's disease: from diagnostic dichotomy to integrative etiology Miia Kivipelto Alina Solomon Tiia Ngandu 178

Section 3 Treatment 193

15 Treatment of cognitive changes Serge Gauthier Timo Erkinjuntti 195

16 Treatment of functional decline Lena Borell 200

17 Treatment of behavioralsymptoms in vascular dementia Catherine Cole Alistair Burns 206

18 Control of vascular risk factors Deborah Gustafson Ingmar Skoog 220

Index 235