Ivan Barbov^1,2,3, Elena Lickova⁴ and Goce Kalcev³*

¹University Clinic of Neurology, Skopje, Republic of North Macedonia
²Faculty of Medicine, St. Cyril and Methodius-Skopje, Skopje, Republic of North Macedonia
³National Alliance for Neuromuscular diseases and Neuroscience, GANGLION Skopje, Skopje, Republic of North Macedonia
⁴Clinical Public Hospital, Stip, North Macedonia

*Corresponding Author: Goce Kalcev, National Alliance for Neuromuscular diseases and Neuroscience, GANGLION Skopje, Skopje, Republic of North Macedonia.

Received: November 06, 2023; Published: December 02, 2023

Abstract

Introduction: Vascular dementia (VaD) is one of the most common causes of dementia in the elderly (those over the age of 65), with a variable presentation and unpredictable disease progression. Current evidence indicates that 25-30% of ischemic stroke patients are likely to develop either immediate or delayed vascular cognitive impairment, or VaD. The development of dementia following a stroke is determined by several factors.

Materials and methods: This study involved 100 patients with ischemic stroke, treated and evaluated for 2 years at the University Clinic of Neurology in Skopje, Republic of North Macedonia, divided into two groups: a group of 47 patients who developed vascular dementia after an ischemic stroke (study group) and a group of 53 patients with ischemic stroke who did not develop vascular dementia (control group).

Results: According to the results of this study, the gender and age differences between the two groups are not statistically significant. Also, there is no statistically significant difference between the affected hemisphere and the appearance or absence of vascular dementia during the evaluation period of two years following the ischemic stroke. On the other hand, a statistically significant difference was found when comparing the distribution of patients with a positive diagnosis for clinically relevant stenosis of one or both carotid arteries with the presence of vascular dementia. No statistically significant difference was found between the representation of four of the five factors (arterial hypertension, diabetes type 2, hyperlipidemia, history of tobacco use) and the occurrence or absence of vascular dementia. Contrary to this, the presence of specific cardiovascular diseases highlights an obvious link with the occurrence of vascular dementia.

Conclusions: Monitoring the risk of vascular disease and preventing recurrent strokes are obviously essential for reducing the burden of cognitive decline and vascular dementia.

Keywords: Vascular Dementia; Ischemic Stroke; Vascular Risk Factors; Clinical Investigations; Comorbidities

References

1. Arvanitakis Zoe., et al. “Diagnosis and Management of Dementia: Review”. JAMA16 (2019): 1589-1599.
2. Burns Alistair and Steve Iliffe. “Dementia”. BMJ (Clinical Research edition.) 338 (2009): b75.
3. Prince Martin., et al. “Recent global trends in the prevalence and incidence of dementia, and survival with dementia”. Alzheimer's Research and Therapy1 (2016): 23-30.
4. Rizzi Liara., et al. “Global epidemiology of dementia: Alzheimer's and vascular types”. BioMed Research International 2014 (2014): 908915.
5. Ji Yong., et al. “Prevalence of dementia and main subtypes in rural northern China”. Dementia and Geriatric Cognitive Disorders5-6 (2015): 294-302.
6. Song Juhyun., et al. “Association between risk factors for vascular dementia and adiponectin”. BioMed Research International 2014 (2014): 261672.
7. https://www.stroke.org/en/about-stroke/effects-of-stroke/cognitive-and-communication-effects-of-stroke/vascular-dementia#:~:text=Vascular%20dementia%2C%20which%20is%20commonly,blood%20vessels%20and%20reduce%20circulation.
8. Kalaria Raj N., et al. “Stroke injury, cognitive impairment and vascular dementia”. Biochimica et Biophysica Acta5 (2016): 915-925.
9. Bevan Steve., et al. “Genetic heritability of ischemic stroke and the contribution of previously reported candidate gene and genomewide associations”. Stroke 12 (2012): 3161-3167.
10. CU Onyike. “Cerebrovascular disease and dementia”. International Review of Psychiatry 18 (2006): 423-431.
11. Moroney JT., et al. “Risk factors for incident dementia after stroke. Role of hypoxic and ischemic disorders”. Stroke 8 (1996): 1283-1289.
12. Rothwell Peter M., et al. “Medical treatment in acute and long-term secondary prevention after transient ischaemic attack and ischaemic stroke”. Lancet (London, England)9778 (2011): 1681-1692.
13. Seshadri Sudha and Philip A Wolf. “Lifetime risk of stroke and dementia: current concepts and estimates from the Framingham Study”. The Lancet. Neurology12 (2007): 1106-1114.
14. Allan Louise M., et al. “Long term incidence of dementia, predictors of mortality and pathological diagnosis in older stroke survivors”. Brain: A Journal of NeurologyPt 12 (2011): 3716-3727.
15. Leys Didier., et al. “Poststroke dementia”. The Lancet. Neurology11 (2005): 752-759.
16. Reitz Christiane., et al. “Relation of plasma lipids to Alzheimer disease and vascular dementia”. Archives of Neurology5 (2004): 705-714.
17. Brouns R and PP De Deyn. “The complexity of neurobiological processes in acute ischemic stroke”. Clinical Neurology and Neurosurgery6 (2009): 483-495.
18. Rami Abdelhaq and Donat Kögel. “Apoptosis meets autophagy-like cell death in the ischemic penumbra: Two sides of the same coin?” Autophagy4 (2008): 422-426.
19. McColl BW., et al. “Systemic inflammation and stroke: aetiology, pathology and targets for therapy”. Biochemical Society Transactions Pt 5 (2007): 1163-1165.

Citation

Citation: Goce Kalcev., et al. “Demographic and Clinical Characteristics of Patients with and Without Vascular Dementia Following an Ischemic Stroke". Acta Scientific Neurology 7.1 (2024): 03-08.

Copyright

Copyright: © 2024 Goce Kalcev., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.