2nd International Congress on Vascular Dementia
Salzburg, austria, january 24-27, 2002



Monduzzi Editore International Proceedings Division Home Page



Over the past century, enormous progress has been achieved regarding our understanding of the dementias. Cognitive decline in the elderly can of course result from many causes, but the contribution of vascular factors is becoming more and more widely appreciated.

Vascular dementia is a vague term, encompassing cognitive impairment resulting from vascular changes. As such, it has multiple etiologies (frequently co-existing in a given patient), which operate through different mechanisms. Risk factors for vascular dementia have been detected and repeatedly confirmed. Very interestingly, many of the risk factors which were identified for Alzheimer’s disease are also involved in vascular dementia. These include hypertension, coronary artery disease and smoking, and possibly also hyperlipidemia and hyperhomocystinemia.

Other analogies between vascular dementia and Alzheimer’s disease are depicted in Table 1.

  Vascular dementia Alzheimer’s disease
Risk factors  Mechanisms
Primary prevention   Secondary prevention
Symptomatic treatment
Well established
Multiple identified
In development
Many identified
Poorly understood
In development
Not available
Partially effective

The fact that vascular dementia is a syndrome is reflected by the multiplicity of causative processes, like hemorrhage or vascular occlusions, and the site of the lesions, e.g. cortical vs subcortical, as well as grey matter vs white matter disorders.

The identification of several genetic factors which can contribute to vascular damage, as well as possible auto-immune damage to vascular components (for example anticardiolipin antibodies), are important. It is remarkable that amyloid precursor protein (APP) mutations can cause the typical pathological changes of Alzheimer’s disease as well as amyloid deposition around blood vessels. These may lead to deficient blood perfusion to the brain, changes of the blood-brain barrier, as well as cerebral hemorrhages.

An unfolding issue relates to the overlap between Alzheimer’s disease and vascular dementia. The mechanisms underlying this overlap are only partly understood (amyloid angiopathy, perivascular amyloid deposits in Alzheimer’s disease), but are probably of even greater importance as reflected by the Nun study, which demonstrated clearly that Alzheimer changes alone may be insufficient to cause dementia, but the addition of vascular brain lesions (usually small, subcortical, clinically unrecognized) were required for the manifestation of dementia (which was then diagnosed clinically as Alzheimer’s disease).

In primary prevention of diseases, it is required to identify risk factors so as to direct attention to those people at higher risk of developing dementia. Thus, it is not yet clear whether the "risk factors" which have been identified in vascular dementia are causative or contributing to the development of cognitive impairment, and which are coexisting but not directly related (e.g. coronary artery disease). Also, host factors such as age and education may have a role but this is yet unproven. Other analogies between vascular dementia and Alzheimer’s disease are depicted in Table 1.

For many years, treatment of vascular disease was oriented towards prevention of heart and kidney failure. Later on, the same classes of drugs were found to help in preventing strokes, and recently their effect against vascular dementia is being described. It is quite possible that their efficacy will extend even further. Epidemiologic and pathological data show that Alzheimer’s disease is associated with vascular risk factors, such as hypertension and coronary artery disease. Thus, attention to these risk factors (as well as others such as hyperlipidemia and smoking) could reduce or delay the incidence of several types of dementia.

Amos D. Korczyn
The Sieratzki Chair in Neurology
Tel-Aviv University Medical School
Ramat-Aviv (Israel)




Vascular Cognitive Impairment Towards Criteria The Concept of Vascular Cognitive Impairment
J.V. Bowler

Subtypes of Sporadic Vascular Dementia
A. Wallin and M. Sjögren

Natural History of Dementia Associated with Lacunar Infarctions
J. Aharon-Peretz, E. Daskovski and T. Mashiach

Embolic Mechanism as a Possible Cause of Simultaneous Small Infarcts in Multiple Vascular Territories
M. Sato, K. Nagata, A. Suzuki and J. Hatazawa

Chronic Misery Perfusion Syndrome Accompanying with Impaired Vascular Reserve
K. Nagata, M. Sato, K. Tsutsumi and J. Hatazawa

Neuropsychological and Neuroimaging Findings in Vascular Dementia and Alzheimer´s Disease
S. Santos, T. Casadevall, C. Tejero, C. Ríos, E. López, P. Larrodé, C. Iñiguez, LF. Pascual, M. Garcés, O. Fabre and F. Morales

Sneddon’s Syndrome and Dementia
C. Tejero, T. Casadevall, L.F. Pascual, S. Santos, I. Navas and E. Mostacero

Amyloid Angiopathy Associated with Cerebral Hemorrhage, Extensive Microhemorrhages and Severe White Matter Edema
S. Salloway, E. Stopa, F. Douglas, J. Wilterdink, J. Rogg and S. Salloway

Genetic, Clinical and Pathological Studies of CADASIL in Japan: A Partial Contribution of Notch3 Mutations and Implications of Smooth Muscle Cell Degeneration for the Pathogenesis
Y. Santa, E. Uyama, D. Hua Chui, M. Arima, S. Kotorii, K. Takahashi and T. Tabira


Validation Study of a CT-based Weighted Rating Scale for Subcortical Cerebrovascular Disease in Patients with Mild Cognitive Deterioration
C. Geroldi, S. Galluzzi, J. Miao, C. Testa and G.B. Frisoni

Leukoaraiosis in Patients Referred to a Dementia Clinic
T.S. Olsen, J.W. Kufahl and P.W. Norup

MRI Subcortical Hyperintensities and Response to Sertraline in Geriatric Depressed Outpatients
S. Salloway, P.A. Boyle, S. Correia, P.F. Malloy, D.A. Cahn-Weiner, L. Schneider, K.R.R. Krishnan and R. Nakra

A NMR Spectroscopy Study on the Effect of Nicergoline Treatment on Brain Metabolism of Aged Rats
F. Conti, A. Miccheli, C. Puccetti, M.E. Di Cocco, A. Battaglia, N. Carfagna, G. Pizzolato and L. Battistin

Cerebral Perfusion Changes Measured with 99m-Technetium HMPAO SPECT After Zolpidem and Flumazenil Intervention
D.W. Oliver, R.P. Clauss, I.C. Dormehl, H.W. Nel, E. Kilian and W.K.A. Louw

Acetazolamide Vasoreactivity in Vascular Dementia
T. Casadevall, S. Santos, P. Razola, C. Tejero, P. Larrodé, C. Iñiguez, LF. Pascual, E. Mostacero, J. Banzo and F. Morales

Electroencephalographic Evaluation of Vascular Dementia
K. Nagata, M. Sato, E. Yokoyama and H. Yuya

Pre-clinical Diagnosis of Alzheimer’s Type Dementia: A Case for Fluorodeoxyglucose Positron Emission Tomography (FDG PET)
A. K. Demetriades

Association Between Cortical Impairment and Subcortical Infarction Assessed Using MRI and 1H MRSI
N. Schuff, A-T. Du, D.L. Amend, W.J. Jagust, B.R. Reed, H.C. Chui and M.W. Weiner


Importance of Depressive Symptoms as Risk Factor for Vascular Dementia
J.S. Meyer and Y.S. Li

Depressive and Anxiety Symptoms in the Acute Stage of Stroke
B.C. Lee, K.H. Yu, H.I. Ma, S. Jung, S.C. Jeong, S.J. Kim, Y.S. Kim and M.H. Lee

DemTect®: A New Screening Instrument with Very High Sensitivity for Vascular and Alzheimer Dementia
E. Kalbe, J. Kessler, R. Smith, R. Bullock, L. Fischer and P. Calabrese

Mini Mental State Examination (MMSE) in Acute Stroke and Seven Years After. The Influence of Age, Stroke Severity, Stroke Recurrence and Stroke Risk Factors. A Community-based Study
T.S. Olsen, L.P. Kammersgaard, H.S. Jørgensen, U.J. Weber,
H. Nakayama, H.O. Raaschou and P.M. Pedersen

Prevalence and Predictors of Impaired Global Cognitive Function in Patients with Minor Stroke and TIA. A Long-term Community-based Follow-up Study
T. Skyhøj Olsen, L.P. Kammersgaard, H.S. Jørgensen, U.J. Weber, H. Nakayama, H.O. Raaschou and P.M. Pedersen


The Role of Cholesterol in the Processing of b-secretase ASP-2
C. Sidera, J. Frimpong Manso, C. Liu and B.M. Austen

Hyperhomocysteinemia and Dementia: A Specific Risk Factor for Subcortical Dementia?
G. Billo, E. Galloni, M. Alecci, T.M. Sgaramella, F. Perini, P. Dudine and V. Toso

Differential Distribution of Smooth Muscle Actin and Agrin in the Microvasculature of the Tg App670,671 Mouse and Alzheimer Brain
E.G. Stopa, J.R. Fallon, S. Salloway, P. Butala, B. Zipser, X. Morales, V. Hovanesian, C. Hulette, J. Ervi, R. Tavare, C. Johanson and M. Vitek

Effect of APOE Genotype on Basement Membrane Agrin and iC3b Levels in Alzheimer’s Disease
T. Gur, T. Berzin, B. Zipser, V. Hovanesian, S. Salloway, J. Fallon, V. Kuo-Leblanc, E. Stopa, D. Glass, C. Hulette, C. Rosenberg and M. Vitek

The Effect of ApoE Genotype of Cells Engaged in b-Amyloidosis on the Response to Oxidative Stress
B. Mazur-Kolecka, D. Kowal, T. Sukontasup, J. Krzeslowska, D. Dickson and J. Frackowiak

Vascular Myocytes Cultured from APP-Swedish Transgenic Mouse Deposit Ab in Lysosomes
J. Frackowiak, B. Mazur-Kolecka, A. Potempska, T. Sukontasup and D. Kowal

Cerebrospinal Fluid Markers of Subcortical Vascular Dementia. Pathophysiological Aspects
M. Sjögren, M. Jonsson and A. Wallin

A New Experimental Model for Sporadic Alzheimer Disease: I. Histopathological Features
R. Sinigaglia-Coimbra, E. Cavalheiro and C. Coimbra

A New Experimental Model for Sporadic Alzheimer Disease: II. Persistent Cognitive Deficits
R. Sinigaglia-Coimbra, A. Carvalho, W. Lacerda, E. Cavalheiro, C. Coimbra and G. Xavier

The Cerebellar Cortex in Vascular Dementia: A Golgi and Electron Microscope Study
S.J. Baloyannis and V. Costa

The Efficacy of Chinese Calligraphic Handwriting (CCH) on Stroke Patients: A Multiple Cases Study
M.L. Chiu, H.S.R. Kao and S.M.Y. Ho


Treatment of Vascular Dementia with Daily 325 mg Oral Aspirin
J.S. Meyer, M.H. Chowdhury and Minh Quach

Feasibility of Vascular Dementia Treatment with Cholinesterase Inhibitors
Y.S. Li, J.S. Meyer, Anwarul Haque, M.H. Chowdhury, G. Xu and Minh Quach

Should We Be Studying Cholinergic Drugs for the Treatment of Vascular Dementia?
H. Geerts and C. Grantham

Galantamine Provides Broad Therapeutic Benefits in Patients with Probable Vascular Dementia or Alzheimer’s Disease with Cerebrovascular Disease
T. Erkinjuntti

Effect of Bromitil on Behavior and Reproductive Function in Male Rats
T.V. Khamidova, N.V. Seredinceva and L. Tchigirinsky Ju.


 Via Maserati 5 Bologna Italy   - Tel. +39 051 4151123   Fax +39 051 370529