The Brief Memory and Executive Test (BMET): A cognitive screening tool to detect and differentiate vascular cognitive impairment and Alzheimer's disease

2017 ◽  
Vol 33 (2) ◽  
pp. e273-e279 ◽  
Author(s):  
Matthew J. Hollocks ◽  
Rebecca L. Brookes ◽  
Robin G. Morris ◽  
Hugh S. Markus
Author(s):  
Francis Cambronero ◽  
Angela L. Jefferson

Hemodynamic impairment is a prominent feature in aging, vascular cognitive impairment and dementia, and Alzheimer’s disease, including patterned changes in cerebral blood flow (CBF) that can be detected prior to concomitant pathologies. These CBF abnormalities drive vascular dysfunction through a variety of biological pathways and ultimately contribute to cerebrovascular disease associated with cognitive impairment. Importantly, the co-existence of cerebrovascular disease and Alzheimer’s disease is exceedingly common and worsens the progression of clinical symptoms, likely through accelerating neurotoxic protein deposition and the loss of cerebrovascular integrity. Emerging evidence further suggests that the brain may be more susceptible to subclinical cardiovascular dysfunction in aging adults, particularly since the accumulation of cardiovascular risk factors over the lifespan creates a more vulnerable vascular system. Although age-associated CBF dysregulation has varied and complex origins, it undoubtedly serves a critical role in the early progression of neurodegenerative disease and may help explain the considerable overlap between the most common clinical dementias.


2018 ◽  
Vol 118 (3) ◽  
pp. 465-473 ◽  
Author(s):  
Maria Isabel D’Avila Freitas ◽  
Claudia S. Porto ◽  
Maira O. Oliveira ◽  
Sonia M. D. Brucki ◽  
Leticia L. Mansur ◽  
...  

2021 ◽  
Vol 20 (3) ◽  
pp. 2677
Author(s):  
O. V. Zimnitskaya ◽  
E. Yu. Mozheyko ◽  
M. M. Petrova

There is currently no approved list of vascular cognitive impairment biomarkers. The main problem for the practitioner in identifying cognitive impairment in patients is the differential diagnosis of Alzheimer's disease, vascular cognitive impairment, and other diseases, which are much less common. Vascular cognitive impairment includes post-stroke dementia, cognitive dysfunction in cardio-and cerebrovascular diseases. Without etiology identification, it is impossible to prescribe adequate treatment. Another challenge is identifying cognitive impairment before dementia develops. This literature review is devoted to the search and critical analysis of candidates for biomarkers of vascular cognitive impairment and the establishment of markers of moderate cognitive dysfunction. The papers were searched for in the Web of Science and PubMed databases. A list of cerebrospinal fluid, plasma, serum and genetic biomarkers was made, allowing for differential diagnosis between vascular impairment and Alzheimer's disease. The markers of moderate cognitive dysfunction, which make it possible to identify cognitive impairment at the pre-dementia stage, were also identified.


Author(s):  
Alyssa M. Lanzi ◽  
James M. Ellison ◽  
Matthew L. Cohen

Purpose Persons with dementia and mild cognitive impairment (MCI) are major consumers of services provided by speech-language pathologists (SLPs). These services include not only direct assessment and treatment of communication and swallowing but also counseling, collaboration, prevention, and wellness. These “counseling+” activities can be especially challenging for SLPs to deliver because of the lack of evidence, as well as the complex nature of Alzheimer's disease (AD) and other conditions that cause MCI and dementia. Method This tutorial is written by a speech-language pathologist, a neuropsychologist, and a geriatric psychiatrist to provide education, resources, and recommendations for SLPs delivering counseling+ activities to patients with MCI and dementia from AD and related disorders. Results and Conclusions We describe counseling+ activities across the continuum of care ranging from educating and conducting cognitive screenings with adults experiencing age-related cognitive decline to supporting end-of-life wishes. Because of their expertise in communication, SLPs can provide an array of important leading and supporting services to patients, their family, and other health care professionals on the care team, such as providing patients with appropriate feedback following a cognitive screening and helping caregivers identify the communicative intent of a responsive behavior. The demand for SLP services for patients with MCI and dementia will grow significantly over the next few decades, necessitating more systematic research and clinical evidence in this area.


Author(s):  
Hugh Markus ◽  
Anthony Pereira ◽  
Geoffrey Cloud

Patients with cerebrovascular disease can develop dementia in the absence of stroke symptoms or as a consequence to stroke. In this chapter, concepts, classification, and definitions of vascular dementia are outlined with a discussion of the overlap between vascular dementia and Alzheimer's disease. Investigation of the vascular dementia patient for treatable causes and to inform management is discussed as there are sections on therapy, promoting independence, and assessments of mental capacity. Depression is common in vascular dementia and a section is dedicated to the assessment and management of this. The concept of mild vascular cognitive impairment is also discussed.


Author(s):  
Rahul Karamchandani ◽  
Nancy R. Barbas

Vascular cognitive impairment (VCI) refers to the spectrum of cognitive disturbances that result from cerebrovascular brain injury. Cerebrovascular disease is associated with multiple underlying pathologies. Risk factors, clinical features, and treatment options overlap with those associated with Alzheimer’s disease, another common cause of cognitive decline. The complexity of vascular cognitive impairment and, notably, the interplay between clinical, pathologic, genetic, and biomarker characteristics of VCI and Alzheimer’s disease are discussed. The chapter places an emphasis on vascular cognitive impairment resulting from disease affecting small vessels, in contrast to that due to disease involving large vessels, in an effort to focus on a large body of evolving work and ongoing attempts at improving understanding of this complex entity.


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