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Vascular disease burden in Indian subjects with vascular dementia
Mina Chandra1, Kuljeet Singh Anand1
1Post Graduate Institute of Medical Education and Research & Dr Ram Manohar Lohia Hospital, New Delhi, India.
Insights
Vascular dementia patients often have multiple vascular conditions, with dyslipidaemia being most common. Higher vascular disease burden correlates with more severe dementia, suggesting it
Area of Science:
- Neurology
- Cardiology
- Endocrinology
Background:
- Vascular dementia is linked to hypertension, diabetes mellitus, dyslipidaemia, and ischaemic heart disease.
- Comorbidity of these vascular factors is frequent in vascular dementia patients.
- This study examined the cumulative impact of these vascular diseases in individuals with vascular dementia.
Purpose of the Study:
- To determine the prevalence of four key vascular disease factors in Indian individuals diagnosed with vascular dementia.
- To assess the vascular disease burden in patients with vascular dementia.
Main Methods:
- 159 subjects with probable vascular dementia (NINDS-AIREN criteria) were evaluated.
- Standardized definitions were used to identify hypertension, diabetes mellitus, dyslipidaemia, and ischaemic heart disease.
- Dementia severity was assessed using the Clinical Dementia Rating (CDR) scale.
Main Results:
- Dyslipidaemia (79.25%) was the most prevalent factor, followed by hypertension (73.58%), ischaemic heart disease (58.49%), and diabetes mellitus (40.80%).
- A significant majority (81.1%) of subjects presented with two or more vascular disease factors.
- A positive correlation was observed between dementia severity and the number of vascular disease factors (p<0.001).
Conclusions:
- Individuals with moderate to severe vascular dementia exhibit a substantially higher burden of vascular diseases.
- Increased vascular disease burden may serve as a negative prognostic indicator for vascular dementia.
- Effective management of vascular dementia requires addressing cognitive decline, functional impairment, and comorbid vascular conditions.
Background:
Vascular disease factors like hypertension, diabetes mellitus, dyslipidaemia, and ischaemic heart disease contribute to the development of vascular dementia. As comorbidity of vascular disease factors in vascular dementia is common, we investigated the vascular disease burden in subjects with vascular dementia.
Aims:
To investigate the vascular disease burden due to four vascular disease factors: hypertension, diabetes mellitus, dyslipidaemia, and ischaemic heart disease in Indian subjects with vascular dementia.
Methods:
In this study, 159 subjects with probable vascular dementia (as per NINDS-AIREN criteria) attending the memory clinic at a tertiary care hospital were assessed for the presence of hypertension, diabetes mellitus, dyslipidaemia, and ischaemic heart disease using standardised operational definitions and for severity of dementia on the Clinical Dementia Rating (CDR) scale. The data obtained was subjected to appropriate statistical analysis.
Results:
Dyslipidaemia (79.25 per cent) was the most common vascular disease factor followed by hypertension (73.58 per cent), ischaemic heart disease (58.49 per cent), and diabetes mellitus (40.80 per cent). Most subjects (81.1 per cent) had two or more vascular disease factors. Subjects with more severe dementia had more vascular disease factors (sig 0.001).
Conclusion:
People with moderate to severe dementia have a significantly higher vascular disease burden; therefore, higher vascular disease burden may be considered as a poor prognostic marker in vascular dementia. Subjects with vascular dementia and their caregivers must manage cognitive impairment and ADL alongside managing serious comorbid vascular diseases that may worsen the dementia.
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