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Case 26 - Vascular Cognitive Impairment

Published online by Cambridge University Press:  09 January 2021

Pedro Rosa-Neto
Affiliation:
McGill University, Montréal
Serge Gauthier
Affiliation:
McGill University, Montréal
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Summary

An 85-year-old woman with hypertension and hyperlipidemia presented with gradual and progressive cognitive impairment for more than 2 years, involving cognitive domains of memory, executive function, visuospatial and mood. She has short-term memory loss such as forgetting whether she has eaten or showered. She will also ask the same questions repeatedly. However, her long-term memory remains intact. She has forgotten how to cook and has recently burnt the pot while cooking on the stove. She is also unable to manage finances and often gives the wrong change while buying her usual groceries. She has lost her way a few times in places where she is familiar with. In addition, she started having mood swings, low mood, and poor sleep. Physical examination reveals mild bilateral bradykinesia, absence of postural or rest tremors, normal limb power, tone and tendon reflexes. She has lower limb apraxia and mild postural instability. Her Mini-Mental State Examination (MMSE) was 16. While she scored 0 for delayed recall, she was able to recall all 3 objects with either category or lexical cueing.

Type
Chapter
Information
Case Studies in Dementia
Common and Uncommon Presentations
, pp. 116 - 119
Publisher: Cambridge University Press
Print publication year: 2021

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References

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Kavirajan, H, Schneider, LS. Efficacy and adverse effects of cholinesterase inhibitors and memantine in vascular dementia: a meta-analysis of randomised controlled trials. Lancet Neurol. 2007;6:782792.CrossRefGoogle ScholarPubMed
Srikanth, VK, Quinn, SJ, Donnan, GA, Saling, MM, Thrift, AG. Long-term cognitive transitions, rates of cognitive change, and predictors of incident dementia in a population-based first-ever stroke cohort. Stroke. 2006;37:24792483.Google Scholar
Sabia, S, Nabi, H, Kivimaki, M, et al. Health behaviors from early to late midlife as predictors of cognitive function: the Whitehall II study. Am J Epidemiol. 2009;170:428437. Accessed at: http://aje.oxfordjournals.org/cgi/content/long/170/4/428.CrossRefGoogle ScholarPubMed
Ngandu, T, Lehtisalo, J, Solomon, A, et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial. Lancet. 2015;385:22552263.Google ScholarPubMed

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