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Mild cognitive impairment with subcortical vascular features: clinical characteristics and outcome

Giovanni B Frisoni1, Samantha Galluzzi, Lorena Bresciani

  • 1Laboratory of Epidemiology & Neuroimaging, IRCCS San Giovanni di Dio--FBF, via Pilastroni 4, 25125 Brescia, Italy. papers@centroAlzheimer.it

Journal of Neurology
|October 17, 2002
PubMed
Abstract

Insights

Individuals with mild cognitive impairment of vascular type (MCI-V) exhibit distinct frontal and gait impairments. These patients face a higher risk of adverse outcomes, including mortality and institutionalization, necessitating early intervention.

Area of Science:

  • Neurology
  • Geriatrics
  • Cognitive Science

Background:

  • Memory clinics encounter patients with cognitive impairment of various etiologies.
  • Differentiating vascular causes from degenerative ones is crucial for prognosis and management.
  • Subcortical vascular dementia (SVD) criteria can aid in identifying vascular cognitive impairment.

Purpose of the Study:

  • To identify non-demented individuals with cognitive impairment due to cerebrovascular etiology (MCI-V) in a memory clinic setting.
  • To characterize the clinical features of MCI-V.
  • To describe the clinical outcome of MCI-V patients.

Main Methods:

  • Prospective study of early cognitive impairment in a Memory Clinic.
  • Used modified Erkinjuntti criteria for MCI-V and Mayo Clinic criteria for degenerative MCI.
  • Compared 29 MCI-V patients with 14 MCI and 21 SVD patients, followed for 32 +/- 8 months.

Main Results:

  • MCI-V patients showed frontal executive dysfunction and parkinsonian gait/balance issues without tremor.
  • At 40 months, 50% of MCI-V and SVD patients died, versus 0% of MCI patients (P=0.03).
  • Among survivors, MCI-V (68%) and SVD (52%) patients had higher rates of nursing home placement, functional loss, or cognitive deterioration than MCI patients (17%) (P=0.02).

Conclusions:

  • Patients with MCI-V present a unique clinical profile identifiable in clinical practice.
  • The high incidence of adverse outcomes in MCI-V underscores the need for prompt preventive strategies.

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