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 170,190 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In this hospital-based study of dementing illnesses in Ibadan, 37 cases were seen over a 6 year period from 1984 to 1989 out of 57,440 cases admitted. The average hospital frequency was 64 cases per 100,000 admissions. Eighteen cases (48.7%) had vascular dementia. The other types encountered were: secondary dementias (8), mixed (5), probable primary degenerative (1) and the remaining 5 cases were unclassifiable. The associated conditions were mainly hypertension, parkinsonism, diabetes mellitus and benign prostatic hyperplasia. The findings confirm the relative rarity of primary degenerative dementia in Nigeria and raise the possibility of prevention of the predominant type by identifying the stroke-prone individuals early and intervening.
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PMID:Clinically-diagnosed dementing illnesses in Ibadan: features, types and associated conditions. 783 14

We compared the incidence of risk factors (such as hypertension, diabetes mellitus, hyperlipidemia, hematocrit, atrial fibrillation) and local cerebral blood flow between patients with lacunar infarction associated with leukoaraiosis (LA) in the centrum semiovale (LACS) and those with periventricular white matter lesions (PVWMLs) on magnetic resonance imagings (MRI). Only atrial fibrillation was more frequently seen in LACS (p < 0.05), but the incidence of other risk factors for cerebrovascular disease was not different between the two patient groups. Demented patients were older than those with preserved intelligence in both groups. Local cerebral blood flow was compared between patients with and without dementia by single photon emission computed tomography using N-isopropyl-p-123I iodoamphetamine (IMP). The cerebral: cerebellar IMP uptake ratio (%) was used as a measure of relative cerebral perfusion. Compared with normal controls the demented patients with PVWMLs showed a significant reduction in local cerebral blood flow in the parietal area (p < 0.05) and the basal gray region (p < 0.05), and those with LACS in the frontal area (p < 0.05) and the basal gray region (p < 0.05). A significant positive correlation was found between local cerebral blood flow and dementia rating scales in the temporal and parietal areas in PVWMLs, and in the frontal area in LACS. These results suggest that most patients with LACS may represent vascular dementia of Binswanger type, and some demented patients with PVWMLs may have Alzheimer type dementia.
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PMID:[Cerebral blood flow patterns in patients with leukoaraiosis and lacunar infarction]. 792 55

We report a patient with long-standing systemic hypertension who developed progressive generalized chorea and dementia beginning at 70 years of age with no family history or other features to suggest Huntington's disease. At postmortem examination, congophilic angiopathy and atherosclerosis causing neostriatal neuronal loss and gliosis were found, in addition to plaques and neurofibrillary tangles in the cortex. This case is a rare demonstration of a vascular pathology causing late onset generalized chorea in association with dementia due to Alzheimer's-type cortical changes.
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PMID:Vascular chorea: case report with pathology. 796 13

This study compares the prevalence rates of 5 common age-dependent diseases in non-demented and demented subjects. Control and dementia populations were approximately age-matched and their numbers also approximated. Prevalence rates for hypertension, myocardial infarction (MI), stroke, cancer and diabetes were determined. The rates of two or more coexisting diseases in the same patient were also compared. Two populations were studied: one was designated the autopsy series, and the other the hospital series. In the autopsy series, the rate of cardiomegaly/hypertension was 1.3 times higher in the control than in the dementia population, and for MI it was 1.7 times higher in the former than in the latter. The rate for stroke was higher in the control group by only a factor of 1.1, for cancer by only a factor of 1.2, and for diabetes the rates were almost identical in the two populations. The rate differences were statistically significant only with respect to cardiomegaly and MI. When the non-vascular and vascular dementias were compared, the rates in the latter were higher by only a factor of 1.3 for cardiomegaly, stroke, cancer and diabetes; for MIs, the rates were about the same in the two dementia categories. The data for two or more coexisting diseases were almost identical in control and dementia autopsy populations. In the hospital series, the hypertension rate was 1.6 times higher in the control than in the Alzheimer's disease (AD) group; for MI, the control group was higher by a factor of 1.5.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Comorbidity of other chronic age-dependent diseases in dementia. 799 23

Vascular dementia and its most common subtype, multi-infarct dementia, are pathologically proven clinical entities. Their prevalence is not as high as previously thought, but they do represent a significant percentage of the population of demented patients. The diagnosis is more difficult to make than is the diagnosis of Alzheimer's disease; however, there are excellent criteria to guide the physician in making the diagnosis. At present the only treatment available is to control the risk factors responsible for the basic disease process; in the majority of cases this requires controlling hypertension.
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PMID:Multi-infarct dementia. 802 33

In recent years, interest in vascular causes of dementia has increased and it has been proposed that vascular dementia (VAD) may be more common than previously supposed. This may have important implications, because VAD at present may be more amenable to prevention and treatment than Alzheimer's disease (AD). Several vascular factors have been related to cognitive decline and dementia in the elderly, including stroke and white matter disease. However, while numerous case-control studies have been concerned with the risk factors for AD, studies on risk factors for VADs are rare. The problems inherent in the diagnostic criteria make it difficult to interpret the results from the few studies that have been performed. Generally, risk factors for multi-infarct dementia are supposed to be the same as those for stroke, and include hypertension, diabetes mellitus, advanced age, male sex, smoking and cardiac diseases. White matter dementia has mainly been related to hypertension. Recent research suggests that vascular factors may also be important in AD, especially in the late-onset type. In stroke patients, dementia has been associated with higher age, less formal education, cerebral atrophy, left-sided or bilateral infarcts, volume of macroscopic infarcts, bilateral symptoms, previous stroke and white matter lesions. The pathogenetic mechanism through which these factors cause dementia is still not clear. Furthermore, it is not known if risk factors for VAD differ from those found in stroke patients. There is now an urgent need for further research on risk factors for VAD and on factors related to dementia in subjects with cerebrovascular disorders.
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PMID:Risk factors for vascular dementia: a review. 808 68

Dementia is a clinical syndrome with many causes. Dementia of the Alzheimer type and vascular dementia account alone or in combination for the vast majority of the dementia in the elderly population. Primary prevention depends on the knowledge of etiopathogenetic mechanisms and the possibility to change contributing factors. In the case of dementia of the Alzheimer type (DAT) contributing factors (risk factors) are emerging. However, they are not easily altered. The protective effect of certain micronutrients, such as antioxidants, remains speculative. The well-established cardiovascular risk factors such as hypertension, diabetes, and overweight are effective in the etiopathogenesis of vascular dementia. Their treatment by diet and drugs is therefore indicated. The protective role of antioxidants is better established in vascular dementia. Antioxidant micronutrients could be an important part of the primary preventive strategy. Whether mental training is effective in primary prevention or not remains controversial. Better training allows the individuals to optimize their resources. In secondary prevention, mental training was shown to be effective in mild dementia (MMS > or = 23), maintaining or even improving function (vascular dementia) and maintaining function for a given time in DAT. In the population with advanced age, mixed forms of dementia become increasingly common. Hence, patients with mild dementia should receive mental training as well as a vigorous treatment of established risk factors.
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PMID:[Is prevention of dementia possible?]. 814 78

A clinicopathological study of senile dementia of Alzheimer's type (SDAT) accompanied by the white matter lesions of Binswanger's type was carried out. Fifty-seven patients, who were diagnosed as suffering from SDAT based on clinical and pathological criteria, were classified into two groups based on the white matter lesions of Binswanger's type. Namely, group 1 consisted of the SDAT patients without any subcortical or white matter lesions (30 cases); group 2 consisted of those with white matter lesions of Binswanger's type (11 cases). The other 9 cases included those with vascular lesions and 4 with some of the same pathological changes found in Parkinson's disease. Clinically, group 2 patients showed subcortical symptoms such as urinary incontinence, Parkinsonian gait, being accompanied by hypertension and arrhythmias. Periventricular lucency (CT) were common in group 2. Macroscopically, both groups showed moderately to severe atrophy, and the width of the corpus callosum of group 2 was narrower than that of group 1. There was no difference in cerebral arteriosclerosis between the groups. In microscopic findings, patients in group 2 showed diffuse distribution of cortical changes such as senile plaques as well as Alzheimer's senile plaques as well as Alzheimer's neurofibrillary tangles while those in group 1 showed various types of diffuse or local distribution. Arteriolosclerosis of the white matter were found in both groups. There was no difference in aortic atherosclerosis and/or heart disease. The complication of white matter lesions of Binswanger's type was not a rare finding in SDAT.
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PMID:[A clinicopathological study of senile dementia of Alzheimer's type (SDAT) and white matter lesions of Binswanger's type]. 820 74

Vascular dementia is seen much more often in people at age 85 than in those between the ages of 55 and 75. The differential diagnosis includes Alzheimer's disease and mixed dementia. The classic criteria for vascular dementia--stepwise deterioration and focal neurologic signs--are important, as focal neurologic signs usually don't occur in Alzheimer's disease. Identifying a significant number of points on the Hachinski scale, including hypertension, can help make a diagnosis of vascular disease. For more effective differential diagnosis, CT or MRI can be useful. However, not all clinicians are convinced of the necessity of imaging, as long as stroke risk factors such as hypertension and hyperlipidemia are managed for all older patients.
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PMID:Vascular dementia: how to make the diagnosis in office practice. 825 93

We report the findings of a total population survey of Thugbah community in the Eastern Province of Saudi Arabia (SA) to determine its point prevalence of neurological diseases. During this two-phase door-to-door study, all Saudi nationals living in Thugbah were first screened by trained interviewers using a pretested questionnaire (sensitivity 98%, specificity 89%) administered at a face-to-face interview. Individuals with abnormal responses were then evaluated by a neurologist using specific guidelines and defined diagnostic criteria to document neurological disease. The questionnaire was readministered blind by a neurologist to all those with abnormal responses and a 1-in-20 random sample of those without abnormal responses, respectively. The family members of an individual with an abnormal response were also screened to improve accuracy. A total of 23,227 Saudis (98% of the eligible subjects) were screened and those residing in Thugbah on the reference date (22,630) were used to calculate the point prevalence rates. Forty-two percent of those screened were in the first decade of life and only 1.5% were more than 60 years old. There were marginally more females (50.2%) than males (49.8%). Consanguineous marriages especially between first cousins were present in 54.6%. The demographic characteristics of Thugbah community were similar to those in other parts of SA. The overall crude prevalence ratio (PR) for all forms of neurological disease was 131/1,000 population. All subsequent PRs are per 1,000 population. Headache syndromes were the most prevalent disorder (PR 20.7). The PR for all seizure disorders was 7.60, and the epilepsies (6.54) were more frequent than febrile convulsions (0.84). Mental retardation, cerebral palsy syndrome, and microcephaly were common pediatric problems with PRs of 6.27, 5.30 and 1.99, respectively. Stroke, Parkinson's disease, and Alzheimer's disease were uncommon with respective PRs of 1.8, 0.27 and 0.22. Central nervous system (CNS) malformations (0.49) such as hydrocephalus and meningomyelocele were more prevalent than spinal muscular atrophy (0.13), congenital brachial palsy (0.13) and narcolepsy (0.04). Multiple sclerosis was rare (0.04). Osteoarthritis and low back pain syndromes were the main non-neurological conditions seen. The major medical diseases that may be neurologically relevant were diabetes mellitus, hypertension, and connective tissue disorders.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:A community survey of neurological disorders in Saudi Arabia: the Thugbah study. 827 77


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