[Vascular damage and cognitive-functional performance in a population with mild cognitive impairment]

There is evidence of predemential stages in Vascular Dementia (VD). Alzheimer Disease (AD) and VD share common risk factors and mechanisms. Vascular comorbility may present in 30-60% of patients with AD (mixed dementia). This work seeks to evaluate the impact of the severity of structural vascular damage according to the Fazekas classification (F) on functional cognitive performance in patients with Mild Cognitive Impairment (MCI).

A cross-sectional study of patients with MCI aged 65 years or older who had brain MRI was carried out. A neurocognitive battery and the EFE (Extended Functional Study) scale were administered to assess complex functionality. The patients were divided according to Fazekas classification: 0-1, 2 and 3. Bivariate analysis and multivariate analysis were performed.

346 patients were included, age: 77.9 (SD 6.1). 66.2% presented F01, 22.8% F2 and 11% F3. Age and MMSE value were statistically significant. Multivariate analysis showed an independent association between vascular damage and complex functional alteration measured by EFE.

In conclusion, the progression of structural damage to a predominance of white matter would affect global cognitive performance and tasks related to executive function. The most significant finding was the correlation of the degree of vascular damage with the deficit of complex functionality measured with clinical tools that include technological resources. The clinical value of identifying individuals with prodromal DV is highlighted as it could optimize prevention measures.