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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Multi-infarct dementia (MID) and dementia of the Alzheimer type (DAT) are the main syndromes in the elderly. This study aims at evaluating the possible differentiation of these syndromes on a clinical basis. The patient population consisted of demented patients hospitalized during the period April 1, 1988-September 30, 1990 at the Department of Cerebrovascular Diseases. The study included 40 patients with MID and 25 with DAT. The clinical diagnosis of dementia included medical history, neurological examination, psychiatric interview and laboratory diagnostic investigations. The severity of the dementia symptoms was rated by many rating scales and a battery of neuropsychological tests. This model of clinical procedure permitted for differential diagnosis between vascular and degenerative dementia, according to DSM-III-R criteria. Patients with multi-infarct dementia of the Alzheimer type did not differ significantly with regard to age, mean duration of cognitive impairment and level of education. In the DAT group women outnumbered men, and this was statistically significant. It should be emphasized, that a great majority of patients with cerebrovascular lesions developed early cognitive impairment, that means within the first year after stroke. In the MID group hypertension, heart disease and smoking were statistically more frequent than in the DAT group. For the preliminary evaluation the severity of cognitive impairment was quantified by Mini-Mental State and Dementia Scale. These scales showed that the degree of dementia was significantly greater in DAT patients as compared to MID patients, whereas the severity of depression assessed by Hamilton's Scale was mild and similar in both group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical and differential diagnosis of multi-infarct dementia and Alzheimer's disease]. 152 70

To evaluate the relative potency of diabetes mellitus as a risk factor for stroke, the relative frequency of stroke symptoms was compared among cohorts with and without diabetes. Stroke symptoms were classified as atherothrombotic cerebral infarctions, transient ischemic attacks, reversible ischemic neurologic deficits, and multi-infarct dementia. The groups were compared according to the occurrence of these symptoms, and both cross-sectional and longitudinal designs were used to study 293 consecutive patients referred to this laboratory and to contrast groups with and without diabetes. Hypertension, heart disease, and stroke symptoms and signs were more frequent among diabetics than among age-matched nondiabetics. Among diabetics, strokes occurred at an earlier age and were more common among men. Regression analyses assigned diabetes second to hypertension as a risk factor for stroke, followed by heart disease and smoking. Diabetes associated with hypertension or hyperlipidemia added significantly to stroke risk. Initially, cerebral blood flow values and cognitive test scores were equivalent among diabetics and nondiabetics; after 3 years, cognition became significantly impaired among diabetics, despite better maintenance of cerebral blood flow among treated diabetics compared with nondiabetics. Diabetes acts to compound risk for stroke not only by promoting cerebral atherogenesis but also by aggravating other risk factors including hypertension, heart disease, and hyperlipidemia.
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PMID:Diabetes mellitus as a risk factor for stroke. 238 56

One hundred and seventy five multi-infarct dementia (MID) patients were evaluated for risk factors for stroke as well as for the types of cerebrovascular lesions that were present. The incidence of associated risk factors for stroke were as follows: hypertension (66%), heart disease (47%), cigarette smoking (37%), diabetes mellitus (20%), moderate alcohol consumption (19%) and hyperlipidaemia (21%). The most frequently occurring type of lesions were multiple lacunar infarctions of the brain (43%). These were combined with other types of stroke in an additional 21%. Atherosclerotic occlusive disease of the carotid and vertebrobasilar arteries occurred alone in 18% and was associated with other types of stroke in another 25%. Embolic cerebral infarctions were present alone in 8% and were combined with other types of stroke in 15%. MID was more frequent in men (62%) than women (p less than 0.002). Mean bihemispheric gray matter cerebral blood flow (CBF) values showed a fluctuating course and when results were pooled and compared between different types of MID, extracranial occlusive disease and/or multiple lacunar infarctions resulted in lowest CBF values. The location of cerebral infarctions was more importantly related to cognitive impairments than was the total volume of infarcted brain. Mortality rates among 125 MID patients followed for 31 months has been 5%. Correct clinical classification of the types of cerebrovascular lesions was confirmed in three necropsied cases.
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PMID:Aetiological considerations and risk factors for multi-infarct dementia. 322 Dec 15

The prevalence and significance of clinical heart disease and hypertension were compared in three groups of elderly patients. One group was diagnosed as dementia of an Alzheimer's type (AD), another as multiinfarct dementia (MID), and the third as major depression. Clinical heart disease and hypertension were uncommon in the AD group with the prevalence being lower than that reported in most epidemiologic studies. Four percent of the AD patients had a history of myocardial infarction, 5% angina, 1% arrhythmias, and 3% heart failure. Electrocardiographic changes of an old myocardial infarction were present in 9%, atrial fibrillation in 1%, and left ventricular hypertrophy in 3%. A history of hypertension was present in 24% of the AD patients. In comparison, a history of myocardial infarction, angina, and heart failure was five times greater, and electrocardiographic abnormalities were twice as prevalent in the MID group. A history of hypertension was three times more common and actual blood pressure readings were higher. In the depression group heart disease was not uncommon and the prevalence, in general, was comparable with the MID group. However, a history of increased blood pressure and actual increased blood pressure readings were statistically less than in the MID group.
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PMID:Prevalence and significance of cardiovascular disease and hypertension in elderly patients with dementia and depression. 401 97

Vascular cognitive impairment, the recent modification of the terminology related to vascular burden of the brain, reflects the all-encompassing effects of vascular disease or lesions on cognition. It incorporates the complex interactions between vascular aetiologies, risk factors and cellular changes within the brain and cognition. The concept covers the frequent poststroke cognitive impairment and dementia, as well as cerebrovascular disease (CVD) as the second most common factor related to dementia. CVD as well as vascular risk factors including arterial hypertension, history of high cholesterol, diabetes or forms of heart disease are independently associated with an increased risk of cognitive impairment and dementia. Traditional vascular risk factors and stroke are also independent factors for the clinical presentation of Alzheimer's disease (AD). In addition to these vascular factors, CVD/strokes, infarcts and white-matter lesions may trigger and modify the progression of AD as the most common cause of neurodegenerative dementia. The main subtypes of previously defined vascular dementia (VaD) include the cortical VaD or multi-infarct dementia also referred as poststroke VaD, subcortical ischaemic vascular disease and dementia or small-vessel dementia and strategic-infarct dementia. Whilst CVD is preventable and treatable, it is clearly a major factor in the prevalence of cognitive impairment in the elderly worldwide.
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PMID:Vascular cognitive deterioration and stroke. 1797 55