This Article Full Text Full Text (PDF) All Versions of this Article: 34/12/2775    most recent 01.STR.0000107480.16433.4Cv1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hachinski, V. Search for Related Content PubMed PubMed Citation Articles by Hachinski, V. Pubmed/NCBI databases Medline Plus Health Information Vascular Diseases

(Stroke. 2003;34:2775.)
© 2003 American Heart Association, Inc.

Editorial

Vascular Behavioral and Cognitive Disorders

From London Sciences Health Center, University of Western Ontario, London, Ontario, Canada.

Correspondence to Dr Vladimir Hachinski, Department of Clinical Neurological Sciences, London Health Sciences Center, 339 Windermere Rd, London, Ontario N6A 5A5 Canada.

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Vascular disease can attack the brain suddenly, causing a stroke, or subtly, inducing cognitive and behavioral changes. Mounting evidence suggests that the risk factors for stroke are also risk factors for cognitive impairment, including Alzheimer’s disease, and that depression can be associated with vascular changes in the brain (www.congrex.com/VAS-COG2003).

Epidemiological surveys tend to be either inclusive and scant or detailed, but focused on one disease. Thus, studies seldom report several illnesses thoroughly enough to look at possible interactions. Canadian statistics suggest that 4.1% of individuals over the age of 65 years have suffered a stroke,¹ twice as many (8%) being demented, and that for every person demented, 2 (16.8%) have cognitive impairment short of dementia.² Could vascular factors underlie all 3 conditions?

A new approach addressing the whole spectrum of cognitive impairment and emphasizing treatment and prevention has been proposed. It suggests that all types of cognitive decline caused or contributed by vascular factors should be addressed in a broad and systematic manner as "vascular cognitive impairment."³ Moreover, the evidence suggests a reciprocal relationship between depression and stroke: depressed patients being more prone to suffering stroke,⁴ and stroke patients being at higher risk for depression.⁵ Furthermore, late-life depression can be associated with leukoaraiosis and subcortical infarcts.⁶

Since the treatment of vascular risk factors can prevent heart attacks and strokes, it may also be possible to avoid mental decline, subtle forms of stroke, and some types of depression. One problem of medicine has been increasing specialization, research focusing on one disease . . . [Full Text of this Article]

This article has been cited by other articles:

				S M C Rasquin, F R J Verhey, R Lousberg, and J Lodder Cognitive performance after first ever stroke related to progression of vascular brain damage: a 2 year follow up CT scan study J. Neurol. Neurosurg. Psychiatry, August 1, 2005; 76(8): 1075 - 1079. [Abstract] [Full Text] [PDF]