Vascular Cognitive Impairment in Clinical Practice

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Vascular cognitive impairment is the second most common cause of dementia after Alzheimer's disease and is expected to grow in prevalence with the aging global population. The purpose of this authoritative book is to give a broad clinical perspective on vascular cognitive impairment and thus create a foundation for the implementation of good dementia care. The book focuses on pathophysiology, diagnosis, treatment and prevention. It demonstrates the underlying causes of the disorder, such as the manner in which vascular risk-factors influence the onset of vascular cognitive impairment. The concept of mixed forms of vascular dementia, Alzheimer's dementia and other vascular diseases is discussed as well as the influence of vascular changes with regard to the onset of Alzheimer's disease. The detailed section on pathophysiology will enhance clinicians' understanding of this complex disorder. Finally there is a section on pharmacological and neuropsychological treatment of cognitive and psychiatric symptoms.

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Editorial Reviews

Doody's Review Service
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.
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Product Details

  • ISBN-13: 9780521875370
  • Publisher: Cambridge University Press
  • Publication date: 2/12/2009
  • Pages: 254
  • Product dimensions: 7.60 (w) x 9.80 (h) x 0.70 (d)

Meet the Author

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.

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Table of Contents

List of contributors; Preface; Part I. Diagnosis: 1. Diagnosing vascular cognitive impairment and dementia - concepts and controversies Timo Erkinjuntti and Serge Gauthier; 2. Vascular cognitive impairment - prodrome to VaD? Adriane Mayda and Charles DeCarli; 3. Clinical evaluation: a systematic but user-friendly approach Oscar L. Lopez and David A. Wolk; 4. Cognitive functioning in vascular dementia before and after diagnosis Erika J. Laukka, Sari Karlsson, Stuart W. S. MacDonald and Lars Bäckman; 5. Structural neuroimaging: CT and MRI Wiesje M. van der Flier, Salka S. Staekenborg, Frederik Barkhof and Philip Scheltens; 6. Functional imaging in vascular dementia - clinical practice Lars-Olof Wahlund and Rimma Axelsson; 7. Biomarkers in vascular dementia Anders Wallin and Tuula Pirttilä; Part II. Pathophysiology: 8. Physio-pathology of large vessel vascular dementia Leonardo Pantoni, Francesca Pescini and Anna Poggesi; 9. Small vessel diseases of the brain Raj N. Kalaria and Timo Erkinjuntti; 10. White matter changes Franz Fazekas, Christian Enzinger, Stefan Ropele and Reinhold Schmidt; 11. Hereditary forms of cerebrovascular amyloidosis Agueda Rostagno and Jorge Ghiso; 12. Role of vascular risk factors in dementia Chengxuan Qiu and Laura Fratiglioni; 13. Cardiovascular disease, cognitive decline, and dementia Angela L. Jefferson and Emelia J. Benjamin; 14. Vascular factors in Alzheimer's disease: from diagnostic dichotomy to integrative etiology Miia Kivipelto, Alina Solomon and Tiia Ngandu; Part III. Treatment: 15. Treatment of cognitive changes Serge Gauthier and Timo Erkinjuntti; 16. Treatment of functional decline Lena Borell; 17. Treatment of behavioral symptoms in vascular dementia Catherine Cole and Alistair Burns; 18. Control of vascular risk factors Deborah Gustafson and Ingmar Skoog; Index.

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