Neuropsychiatric Aspects of Vascular Cognitive Impairment

Chapter

Abstract

Neuropsychiatric disorders such as dementia and depression are common in the elderly. After the age of 85, the prevalence of dementia is 30%, that of depression 10%, and that of psychotic symptoms 10%. The lifetime prevalence of depression approaches 50% in women and 25% in men. Cognitive dysfunction is common both in depression and in individuals with psychotic symptoms, and it is the core manifestation in dementia disorders, such as Alzheimer’s disease. Cognitive symptoms are also included in the criteria for major depression in the DSM-IV. There is controversy about whether depression is a risk factor for dementia, but depression is common in individuals with dementia. Cognitive dysfunction in elderly individuals may also be caused by prodromal symptoms of dementia. Cerebrovascular diseases are also common in the elderly and are related to both cognitive impairment and depression. Vascular cognitive impairment is a term encompassing vascular causes of cognitive impairment, including dementia. The two most common cerebrovascular diseases are stroke and ischemic white matter lesions (WMLs). Stroke and ischemic WMLs increase the risk for dementia and depression. The latter is a reason for the introduction of the concept of vascular depression in the elderly. However, most depressions in the elderly are not related to vascular disease. Adding to the complexity, associations between cerebrovascular and neuropsychiatric disorders may also go in the opposite direction, as several studies report that depression may increase the risk for stroke. There is thus a complex interaction between depression, dementia, and vascular diseases. It is important to detect neuropsychiatric syndromes in patients with cardiovascular diseases as this has implications for their management and prognosis. Vascular disorders and risk factors are also important to detect as they are targets for prevention of dementia and depression.

Keywords

Alzheimer’s disease Cerebrovascular disease Dementia Depression White matter lesions 
This is a preview of subscription content, log in to check access.

References

  1. 1.
    Bowler JV, Hachinski V (1995) Vascular cognitive impairment: a new approach to vascular dementia. Baillieres Clin Neurol 4:357–376Google Scholar
  2. 2.
    Langa KM, Foster NL, Larson EB (2004) Mixed dementia. Emerging concepts and therapeutic implications. JAMA 292:2901–2908PubMedCrossRefGoogle Scholar
  3. 3.
    Alexopoulos GS, Meyers BS, Young RC et al (1997) ‘Vascular depression’ hypothesis. Arch Gen Psychiatry 54:915–922PubMedCrossRefGoogle Scholar
  4. 4.
    McKhann G, Drachman D, Folstein M et al (1984) Clinical diagnosis of Alzheimer’s disease: Report of the NINCDS-ADRDA work group under the auspices of department of health and human services task force on Alzheimer’s disease. Neurology 34:939–944PubMedCrossRefGoogle Scholar
  5. 5.
    Sacuiu S, Sjögren M, Gustafson D et al (2005) Prodromal cognitive signs of dementia in 85-year-olds using four sources of information. Neurology 65:1894–1900PubMedCrossRefGoogle Scholar
  6. 6.
    Sacuiu S, Gustafson D, Johansson B et al (2009) The pattern of cognitive symptoms predicts time to dementia onset. Alzheimers Dement 5:199–206PubMedCrossRefGoogle Scholar
  7. 7.
    Tomlinson B, Henderson G (1976) Some quantitative cerebral findings in normal and demented old people. In: Terry RD (ed) Neurobiology of aging. Raven, New YorkGoogle Scholar
  8. 8.
    White L, Petrovich H, Hardman J et al (2002) Cerebrovascular pathology and dementia in autopsied Honolulu-Asia Aging Study participants. Ann NY Acad Sci 977:9–23PubMedCrossRefGoogle Scholar
  9. 9.
    Group N (2001) Medical Research Council Cognitive Function and Aging Study. Pathological correlates of late-onset dementia in a multicentre, community-based population in England and Wales. Lancet 357:169–175CrossRefGoogle Scholar
  10. 10.
    Davies L, Wolska B, Hilbich C et al (1988) A4 amyloid protein deposition and the diagnosis of Alzheimer’s disease: prevalence in aged brains determined by immunocytochemistry compared with conventional neuropathologic techniques. Neurology 38:1688–1693PubMedCrossRefGoogle Scholar
  11. 11.
    Delaère P, He Y, Fayet G et al (1993) bA4 deposits are constant in the brain of the oldest old: an immunocytochemical study of 20 French centenarians. Neurobiol Aging 14:191–194PubMedCrossRefGoogle Scholar
  12. 12.
    Snowdon D, Greiner L, Mortimer J et al (1997) Brain infarction and the clinical expression of Alzheimer disease. The Nun Study. JAMA 277:813–817PubMedCrossRefGoogle Scholar
  13. 13.
    Aizenstein HJ, Nebes RD, Saxton JA et al (2008) Frequent amyloid deposition without significant cognitive impairment among the elderly. Arch Neurol 65:1509–1517PubMedCrossRefGoogle Scholar
  14. 14.
    American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, Washington, DCGoogle Scholar
  15. 15.
    Skoog I (2008) Mental disorders associated with aging. In: Heggenhougen K, Quah S (eds) International encyclopedia of public health, vol 6. Academic, San Diego, pp 174–182CrossRefGoogle Scholar
  16. 16.
    Ernst C, Angst J (1995) Depression in old age. Is there a real decrease in prevalence? A review. Eur Arch Psychiatry Clin Neurosci 245:272–287PubMedCrossRefGoogle Scholar
  17. 17.
    Riedel-Heller SG, Busse A, Angermeyer MC (2006) The state of mental health in old-age across the ‘old’ European Union – a systematic review. Acta Psychiatr Scand 113:388–401PubMedCrossRefGoogle Scholar
  18. 18.
    Skoog I, Nilsson L, Landahl S et al (1993) Mental disorders and the use of psychotropic drugs in an 85-year-old urban population. Int Psychogeriatr 5:33–48PubMedCrossRefGoogle Scholar
  19. 19.
    Beekman ATF, Deeg DJH, van Tilburg T et al (1995) Major and minor depression in later life: a study of prevalence and risk factors. J Affect Disord 36:65–75PubMedCrossRefGoogle Scholar
  20. 20.
    Ritchie K, Artero S, Beluche I et al (2004) Prevalence of DSM-IV psychiatric disorder in the French elderly population. Br J Psychiatry 184:147–152PubMedCrossRefGoogle Scholar
  21. 21.
    McDougall FA, Kvaal K, Matthews FE et al (2007) Medical Research Council Cognitive Function and Ageing Study. Prevalence of depression in older people in England and Wales: the MRC CFA Study. Psychol Med 37:1787–1795PubMedCrossRefGoogle Scholar
  22. 22.
    Steffens DC, Skoog I, Norton MC et al (2000) Prevalence of depression and its treatment in an elderly population: the Cache County study. Arch Gen Psychiatry 57:601–607PubMedCrossRefGoogle Scholar
  23. 23.
    Jorm AF (2000) Does old age reduce the risk of anxiety and depression? A review of epidemiological studies across the adult life span. Psychol Med 30:11–22PubMedCrossRefGoogle Scholar
  24. 24.
    Palsson S, Skoog I (1997) The epidemiology of affective disorders in the elderly: a review. Int Clin Psychopharm 12(suppl 2):S3–S13CrossRefGoogle Scholar
  25. 25.
    Palsson SP, Östling S, Skoog I (2001) The incidence of first-onset depression in a population followed from the age of 70 to 85. Psychol Med 31:1159–1168PubMedGoogle Scholar
  26. 26.
    Palsson S, Johansson B, Berg S et al (2000) A population study on the influence of depression on neuropsychological functioning in 85-year-olds. Acta Psychiatr Scand 101:185–193PubMedCrossRefGoogle Scholar
  27. 27.
    Persson G, Skoog I (1992) Subclinical dementia: relevance of cognitive and affective symptoms and signs. A nine year prospective study. J Geriatr Psychiatry Neurol 5:172–178PubMedGoogle Scholar
  28. 28.
    Copeland JRM, Davidson IA, Dewey ME et al (1992) Alzheimer’s disease, other dementias, depression and pseudodementia: prevalence, incidence and three-year outcome in Liverpool. Br J Psychiatry 161:230–239PubMedCrossRefGoogle Scholar
  29. 29.
    Henderson AS, Korten AE, Jacomb PA et al (1997) The course of depression in the elderly: a longitudinal community-based study in Australia. Psychol Med 27:119–129PubMedCrossRefGoogle Scholar
  30. 30.
    Palsson S (2000) Population studies on depression in the elderly. Prevalence, incidence and relation to cognitive function and dementia. Dissertation, University of GothenburgGoogle Scholar
  31. 31.
    Ownby RL, Crocco E, Acevedo A et al (2006) Depression and risk for Alzheimer disease: systematic review, meta-analysis, and metaregression analysis. Arch Gen Psychiatry 63:530–538PubMedCrossRefGoogle Scholar
  32. 32.
    Skoog I (1993) The prevalence of psychotic, depressive and anxiety syndromes in demented and non-demented 85-year-olds. Int J Geriatr Psychiatry 8:247–253CrossRefGoogle Scholar
  33. 33.
    Savva GM, Zaccai J, Matthews FE et al (2009) Medical Research Council Cognitive Function and Ageing Study. Prevalence, correlates and course of behavioural and psychological symptoms of dementia in the population. Br J Psychiatry 194:212–219PubMedCrossRefGoogle Scholar
  34. 34.
    Petrovic M, Hurt C, Collins D et al (2007) Clustering of behavioural and psychological symptoms in dementia (BPSD): a European Alzheimer’s disease consortium (EADC) study. Acta Clin Belg 62:426–432PubMedGoogle Scholar
  35. 35.
    Östling S, Skoog I (2002) Psychotic symptoms and paranoid ideation in a nondemented population-based sample of the very old. Arch Gen Psychiatry 59:53–59PubMedCrossRefGoogle Scholar
  36. 36.
    Östling S, Börjesson-Hansson A, Skoog I (2007) Psychotic symptoms and paranoid ideation in a population-based sample of 95-year-olds. Am J Geriatr Psychiatry 15:999–1004PubMedCrossRefGoogle Scholar
  37. 37.
    Sigström R, Skoog I, Sacuiu S et al (in press) The prevalence of psychotic symptoms and paranoid ideation in a non-demented population sample of 70-82 year olds. Int J Geriatr PsychiatryGoogle Scholar
  38. 38.
    Östling S, Johansson B, Skoog I (2004) Cognitive test performance in relation to psychotic symptoms and paranoid ideation in non-demented 85-year-olds. Psychol Med 34:443–450PubMedCrossRefGoogle Scholar
  39. 39.
    Skoog I (2006) Vascular dementia. In: Pathy MSJ, Sinclair AJ, Morley JE (eds) Principles and practice of geriatric medicine, 4th edn. Wiley, Chichester, pp 1103–1110Google Scholar
  40. 40.
    Breteler MMB, Claus JJ, Grobbee DE et al (1994) Cardiovascular disease and distribution of cognitive function in elderly people: the Rotterdam Study. BMJ 308:1604–1608PubMedCrossRefGoogle Scholar
  41. 41.
    Breteler MMB, van Swieten JC, Bots ML et al (1994) Cerebral white matter lesions, vascular risk factors, and cognitive function in a population-based study: the Rotterdam Study. Neurology 44:1246–1252PubMedCrossRefGoogle Scholar
  42. 42.
    Breteler MMB, van Amerongen NM, van Swieten JC et al (1994) Cognitive correlates of ventricular enlargement and cerebral white matter lesions on magnetic resonance imaging. The Rotterdam Study. Stroke 25:1109–1115PubMedCrossRefGoogle Scholar
  43. 43.
    Skoog I, Berg S, Johansson B et al (1996) The influence of white matter lesions on neuropsychological functioning in demented and non-demented 85-year-olds. Acta Neurol Scand 93:142–148PubMedCrossRefGoogle Scholar
  44. 44.
    Linden T, Skoog I, Fagerberg B et al (2004) Cognitive impairment and dementia 20 months after stroke. Neuroepidemiology 23:45–52PubMedCrossRefGoogle Scholar
  45. 45.
    Qiu C, Skoog I, Fratiglioni L (2002) Occurrence and determinants of Vascular Cognitive Impairment. In: Erkinjuntti T, Gauthier S (eds) Vascular cognitive impairment. Martin Dunitz, London, pp 61–83Google Scholar
  46. 46.
    Tatemichi TK, Desmond DW, Mayeux R et al (1992) Dementia after stroke: baseline frequency, risks, and clinical features in a hospitalized cohort. Neurology 42:1185–1193PubMedCrossRefGoogle Scholar
  47. 47.
    Tatemichi TK, Desmond DW, Paik M et al (1993) Clinical determinants of dementia related to stroke. Ann Neurol 33:568–575PubMedCrossRefGoogle Scholar
  48. 48.
    Tatemichi TK, Paik M, Bagiella E et al (1994) Dementia after stroke is a predictor of long-time survival. Stroke 25:1915–1919PubMedCrossRefGoogle Scholar
  49. 49.
    Pohjasvaara T, Erkinjuntti T, Vataja R et al (1997) Dementia three months after stroke. Baseline frequency and effect of different definitions of dementia in the Helsinki Stroke Aging Memory (SAM) cohort. Stroke 28:785–792PubMedCrossRefGoogle Scholar
  50. 50.
    Liebetrau M, Steen B, Skoog I (2003) Stroke in 85-year-olds. Prevalence, incidence, risk factors and relation to mortality and dementia. Stroke 34:2617–2622PubMedCrossRefGoogle Scholar
  51. 51.
    Skoog I (1998) Guest editorial. Status of risk factors for vascular dementia. Neuroepidemiology 17:2–9PubMedCrossRefGoogle Scholar
  52. 52.
    Barker WW, Luis CA, Kashuba A et al (2002) Relative frequencies of Alzheimer disease, Lewy body, vascular and frontotemporal dementia, and hippocampal sclerosis in the State of Florida Brain Bank. Alzheimer Dis Assoc Disord 16:203–212PubMedCrossRefGoogle Scholar
  53. 53.
    Fischer P, Gatterer G, Marterer A et al (1990) Course characteristics in the differentiation of dementia of the Alzheimer type and multi-infarct dementia. Acta Psychiatr Scand 81:551–553PubMedCrossRefGoogle Scholar
  54. 54.
    Ferrucci L, Guralnik J, Salive M et al (1996) Cognitive impairment and risk of stroke in the older population. J Am Geriatr Soc 44:237–241PubMedGoogle Scholar
  55. 55.
    Gale C, Martyn C, Cooper C (1996) Cognitive impairment and mortality in a cohort of elderly people. Br Med J 312:608–611CrossRefGoogle Scholar
  56. 56.
    Zhu L, Fratiglioni L, Guo Z et al (2000) Incidence of stroke in relation to cognitive function and dementia in the Kungsholmen Project. Neurology 54:2103–2107PubMedCrossRefGoogle Scholar
  57. 57.
    Folstein MF, Maiberger R, McHugh PR (1977) Mood disorder as a specific complication of stroke. J Neurol Neurosurg Psychiatry 40:1018–1020PubMedCrossRefGoogle Scholar
  58. 58.
    Rao R, Jackson S, Howard R (2001) Depression in older people with mild stroke, carotid stenosis and peripheral vascular disease: a comparison with healthy controls. Int J Geriatr Psychiatry 16:175–183PubMedCrossRefGoogle Scholar
  59. 59.
    Burvill PW, Johnson GA, Jamrozik KD et al (1995) Prevalence of depression after stroke: the Perth Community Stroke Study. Br J Psychiatry 166:320–327PubMedCrossRefGoogle Scholar
  60. 60.
    Ng KC, Chan KL, Straughan PT (1995) A study of post-stroke depression in a rehabilitative center. Acta Psychiatr Scand 92:75–79PubMedCrossRefGoogle Scholar
  61. 61.
    Pohjasvaara T, Leppavuori A, Siira I et al (1998) Frequency and clinical determinants of poststroke depression. Stroke 29:2311–2317PubMedCrossRefGoogle Scholar
  62. 62.
    Linden L, Blomstrand C, Skoog I (2007) Depressive disorders after 20 months in elderly stroke patients. A case-control study. Stroke 38:1860–1863PubMedCrossRefGoogle Scholar
  63. 63.
    Astrom M, Adolfsson R, Asplund K (1993) Major depression in stroke patients. A 3-year longitudinal study. Stroke 24:976–982PubMedCrossRefGoogle Scholar
  64. 64.
    Kauhanen ML, Korpelainen JT, Hiltunen P et al (2000) Aphasia, depression, and non-verbal cognitive impairment in ischaemic stroke. Cerebrovasc Dis 10:455–461PubMedCrossRefGoogle Scholar
  65. 65.
    Hackett ML, Yapa C, Parag V et al (2005) Frequency of depression after stroke: a systematic review of observational studies. Stroke 36:1330–1340PubMedCrossRefGoogle Scholar
  66. 66.
    Hackett ML, Anderson CS (2005) Predictors of depression after stroke: a systematic review of observational studies. Stroke 36:2296–2301PubMedCrossRefGoogle Scholar
  67. 67.
    Ramasubbu R, Robinson RG, Flint AJ et al (1998) Functional impairment associated with acute poststroke depression: the Stroke Data Bank Study. J Neuropsychiatry Clin Neurosci 10:26–33PubMedGoogle Scholar
  68. 68.
    Schulz R, Beach SR, Ives DG et al (2000) Association between depression and mortality in older adults: the Cardiovascular Health Study. Arch Intern Med 160:1761–1768PubMedCrossRefGoogle Scholar
  69. 69.
    Pohjasvaara T, Vataja R, Leppavuori A et al (2001) Depression is an independent predictor of poor long-term functional outcome post-stroke. Eur J Neurol 8:315–319PubMedCrossRefGoogle Scholar
  70. 70.
    Schubert DS, Taylor C, Lee S et al (1992) Detection of depression in the stroke patient. Psychosomatics 33:290–294PubMedCrossRefGoogle Scholar
  71. 71.
    Kotila M, Numminen H, Waltimo O et al (1999) Post-stroke depression and functional recovery in a population-based stroke register. The Finnstroke study. Eur J Neurol 6:309–312PubMedCrossRefGoogle Scholar
  72. 72.
    Beblo T, Wallesch CW, Herrmann M (1999) The crucial role of frontostriatal circuits for depressive disorders in the postacute stage after stroke. Neuropsychiatry Neuropsychol Behav Neurol 12:236–246PubMedGoogle Scholar
  73. 73.
    Vataja R, Pohjasvaara T, Leppavuori A et al (2001) Magnetic resonance imaging correlates of depression after ischemic stroke. Arch Gen Psychiatry 58:925–931PubMedCrossRefGoogle Scholar
  74. 74.
    Starkstein SE, Robinson RG, Honig MA et al (1989) Mood changes after right-hemisphere lesions. Br J Psychiatry 155:79–85PubMedCrossRefGoogle Scholar
  75. 75.
    Carson AJ, MacHale S, Allen K et al (2000) Depression after stroke and lesion location: a systematic review. Lancet 356:122–126PubMedCrossRefGoogle Scholar
  76. 76.
    Kneebone II, Dunmore E (2000) Psychological management of post-stroke depression. Br J Clin Psychol 39:53–65PubMedCrossRefGoogle Scholar
  77. 77.
    Bos MJ, Lindén T, Koudstaal PJ et al (2008) Depressive symptoms and risk of stroke: the Rotterdam Study. J Neurol Neurosurg Psychiatry 79:997–1001PubMedCrossRefGoogle Scholar
  78. 78.
    Liebetrau M, Steen B, Skoog I (2008) Depression as a risk factor for the incidence of first-ever stroke in 85-year-olds. Stroke 39:1960–1965PubMedCrossRefGoogle Scholar
  79. 79.
    Salaycik KJ, Kelly-Hayes M, Beiser A et al (2007) Depressive symptoms and risk of stroke: the Framingham Study. Stroke 38:16–21PubMedCrossRefGoogle Scholar
  80. 80.
    Frasure-Smith N, Lesperance F, Talajic M (1995) Depression and 18-month prognosis after myocardial infarction. Circulation 91:999–1005PubMedCrossRefGoogle Scholar
  81. 81.
    Musselman DL, Tomer A, Manatunga AK et al (1996) Exaggerated platelet reactivity in major depression. Am J Psychiatry 153:1313–1317PubMedGoogle Scholar
  82. 82.
    Okamura F, Tashiro A, Utumi A et al (2000) Insulin resistance in patients with depression and its changes during the clinical course of depression: minimal model analysis. Metabolism 49:1255–1260PubMedCrossRefGoogle Scholar
  83. 83.
    Vermeer SE, Koudstaal PJ, Oudkerk M et al (2002) Prevalence and risk factors of silent brain infarcts in the population-based Rotterdam Scan Study. Stroke 33:21–25PubMedCrossRefGoogle Scholar
  84. 84.
    Vermeer SE, Prins ND, Den Heijer T et al (2003) Silent brain infarcts and the risk of dementia and cognitive decline. N Engl J Med 348:1215–1222PubMedCrossRefGoogle Scholar
  85. 85.
    Liebetrau M, Steen B, Hamann GF et al (2004) Silent and symptomatic infarcts on cranial computerized tomography in relation to dementia and mortality. A population-based study in 85-year-olds. Stroke 35:1816–1820PubMedCrossRefGoogle Scholar
  86. 86.
    Fernando MS, Ince PG, on behalf of the MRC Cognitive function and Ageing Neuropathology Study Group (2004) Vascular pathologies and cognition in a population-based cohort of elderly people. J Neurol Sci 226:13–17CrossRefGoogle Scholar
  87. 87.
    Román GC (1987) Senile dementia of the Binswanger type. A vascular form of dementia in the elderly. JAMA 258:1782–1788PubMedCrossRefGoogle Scholar
  88. 88.
    Brun A, Englund E (1986) A white matter disorder in dementia of the Alzheimer type: A pathoanatomical study. Ann Neurol 19:253–262PubMedCrossRefGoogle Scholar
  89. 89.
    Englund E, Brun A (1990) White matter changes in dementia of Alzheimer’s type. The difference in vulnerability between cell compartments. Histopathology (Oxf) 16:433–439CrossRefGoogle Scholar
  90. 90.
    Skoog I, Gustafson D (2003) Hypertension, hypertension-clustering factors and Alzheimer’s disease. Neurol Res 25:675–680PubMedCrossRefGoogle Scholar
  91. 91.
    Guo X, Pantoni L, Simoni M et al (2009) Midlife blood pressure and late-life white matter lesions: the Prospective Population Study of Women in Gothenburg, Sweden. Hypertension 54:57–62PubMedCrossRefGoogle Scholar
  92. 92.
    Skoog I, Palmertz B, Andreasson L-A (1994) The prevalence of white matter lesions on computed tomography of the brain in demented and non-demented 85-year-olds. J Geriatr Psychiatry Neurol 7:169–175PubMedGoogle Scholar
  93. 93.
    Lopez OL, Becker JT, Jungreis CA et al (1995) Computed tomography–but not magnetic resonance imaging–identified periventricular white-matter lesions predict symptomatic cerebrovascular disease in probable Alzheimer’s disease. Arch Neurol 52:659–664PubMedCrossRefGoogle Scholar
  94. 94.
    Simoni M, Pantoni L, Pracucci G et al (2008) Prevalence of CT-detected cerebral abnormalities in an elderly Swedish population sample. Acta Neurol Scand 118:260–267PubMedCrossRefGoogle Scholar
  95. 95.
    De la Monte S (1989) Quantitation of cerebral atrophy in preclinical and end-stage Alzheimer’s disease. Ann Neurol 25:450–459PubMedCrossRefGoogle Scholar
  96. 96.
    Prins ND, van Dijk EJ, den Heijer T et al (2004) Cerebral white matter lesions and the risk of dementia. Arch Neurol 61:1531–1534PubMedCrossRefGoogle Scholar
  97. 97.
    Gunstad J, Brickman AM, Paul RH et al (2005) Progressive morphometric and cognitive changes in vascular dementia. Arch Clin Neuropsychol 20:229–241PubMedCrossRefGoogle Scholar
  98. 98.
    Schmidt R, Enzinger C, Ropele S et al (2003) Austrian Stroke Prevention Study. Progression of cerebral white matter lesions: 6-year results of the Austrian Stroke Prevention Study. Lancet 361:2046–2048PubMedCrossRefGoogle Scholar
  99. ;99.
    Herrmann LL, Le Masurier M, Ebmeier KP (2008) White matter hyperintensities in late life depression: a systematic review. J Neurol Neurosurg Psychiatry 79:619–624PubMedCrossRefGoogle Scholar
  100. 100.
    Steffens DC, Krishnan KR, Crump C et al (2002) Cerebrovascular disease and evolution of depressive symptoms in the cardiovascular health study. Stroke 33:1636–1644PubMedCrossRefGoogle Scholar
  101. 101.
    Teodorczuk A, Firbank MJ, Pantoni L et al (2009) Relationship between baseline white-matter changes and development of late-life depressive symptoms: 3-year results from the LADIS study. Psychol Med 12:1–8CrossRefGoogle Scholar
  102. 102.
    Greenwald BS, Kramer-Ginsberg E, Krishnan KR et al (1998) Neuroanatomic localization of magnetic resonance imaging signal hyperintensities in geriatric depression. Stroke 29:613–617PubMedCrossRefGoogle Scholar
  103. 103.
    O’Brien J, Ames D, Chiu E et al (1998) Severe deep white matter lesions and outcome in elderly patients with major depressive disorder: follow up study. BMJ 317:982–984PubMedCrossRefGoogle Scholar
  104. 104.
    Simpson S, Baldwin RC, Jackson A et al (1998) Is subcortical disease associated with a poor response to antidepressants? Neurological, neuropsychological and neuroradiological findings in late-life depression. Psychol Med 28:1015–1026PubMedCrossRefGoogle Scholar
  105. 105.
    Chen PS, McQuoid DR, Payne ME et al (2006) White matter and subcortical gray matter lesion volume changes and late-life depression outcome: a 4-year magnetic resonance imaging study. Int Psychogeriatr 18:445–456PubMedCrossRefGoogle Scholar
  106. 106.
    Lim A, Tsuang D, Kukull W et al (1999) Clinico-neuropathological correlation of Alzheimer’s disease in a community-based case series. J Am Geriatr Soc 47:564–569PubMedGoogle Scholar
  107. 107.
    Nagy Z, Esiri M, Jobst K et al (1997) The effects of additional pathology on the cognitive deficit in Alzheimer disease. J Neuropathol Exp Neurol 56:165–170PubMedCrossRefGoogle Scholar
  108. 108.
    Heyman A, Fillenbaum G, Welsh-Bohmer K et al (1998) Cerebral infarcts in patients with autopsy-proven Alzheimer’s disease: CERAD, part XVIII. Consortium to Establish a Registry for Alzheimer’s Disease. Neurology 51:159–162PubMedCrossRefGoogle Scholar
  109. 109.
    Etiene D, Kraft J, Ganju N et al (1998) Cerebrovascular pathology contributes to the heterogeneity of Alzheimer’s disease. J Alzheimers Dis 1:119–134PubMedGoogle Scholar
  110. 110.
    Erkinjuntti T, Hachinski V (1993) Dementia post stroke. In: Teasell R (ed) Physical medicine and rehabilitation: state of the art reviews, vol 7. Hanley & Belfus, Philadelphia, pp 195–212Google Scholar
  111. 111.
    Pasquier F, Leys D (1997) Why are stroke patients prone to develop dementia? J Neurol 244:135–142PubMedCrossRefGoogle Scholar
  112. 112.
    Skoog I, Nilsson L, Palmertz B et al (1993) A population-based study of dementia in 85-year-olds [see comments]. N Engl J Med 328:153–158PubMedCrossRefGoogle Scholar
  113. 113.
    Wetterling T, Kanitz R-D, Borgis K-J (1996) Comparison of different diagnostic criteria for vascular dementia (ADDTC, DSM-IV, ICD-10, NINDS-AIREN). Stroke 27:30–36PubMedCrossRefGoogle Scholar
  114. 114.
    Amar K, Wilcock G, Scott M (1996) The diagnosis of vascular dementia in the light of the new criteria. Age Ageing 25:51–55PubMedCrossRefGoogle Scholar
  115. 115.
    Skoog I, Gustafson D (2006) Lessons learned from primary prevention trials in dementia. In: Rockwood K, Gauthier S (eds) Trial designs and outcomes in dementia therapeutic research. Taylor & Francis, Abingdon, pp 189–211Google Scholar

Copyright information

© Springer 2010

Authors and Affiliations

  1. 1.Neuropsychiatric Epidemiology Unit, Department of PsychiatryInstitute of Neuroscience and Physiology, Sahlgrenska Academy at Göteborg UniversityGöteborgSweden

Personalised recommendations