Vascular dementia: Diagnostic criteria and supplementary exams: Recommendations of the Scientific Department of Cognitive Neurology and Aging of the Brazilian Academy of Neurology. Part I.

Engelhardt, Eliasz; Tocquer, Carla; André, Charles; Moreira, Denise Madeira; Okamoto, Ivan Hideyo; Cavalcanti, José Luiz de Sá

doi:10.1590/S1980-57642011DN05040003

Abstract

Vascular dementia (VaD) is the most prevalent form of secondary dementia and the second most common of all dementias. The present paper aims to define guidelines on the basic principles for treating patients with suspected VaD (and vascular cognitive impairment - no dementia) using an evidence-based, systematized approach. The knowledge used to define these guidelines was retrieved from searches of several databases (Medline, Scielo, Lilacs) containing scientific articles, systematic reviews, meta-analyses, largely published within the last 15 years or earlier when pertinent. Information retrieved and selected for relevance was used to analyze diagnostic criteria and to propose a diagnostic system encompassing diagnostic criteria, anamnesis, as well as supplementary and clinical exams (neuroimaging and laboratory). Wherever possible, instruments were selected that had versions previously adapted and validated for use in Brazil that take into account both schooling and age. This task led to proposed protocols for supplementary exams based on degree of priority, for application in clinical practice and research settings.

Key words:
recommendations; vascular dementia; criteria; neuroimaging; laboratory exams.

Resumo

A demência vascular (DV) é a forma mais prevalente de demência secundária e asegunda forma mais comum. O presente artigo visa definir recomendações dos princípios básicos para tratamento dos pacientes com suspeita de DV (e comprometimento cognitivo leve sem demência) usando uma abordagem sistematizada baseada em evidências. O conhecimento usado para definir estas recomendações foi recuperado de pesquisa de várias bases de dados (Medline, Scielo, Lilacs) contendo artigos científicos, revisões sistemáticas, meta-análises, publicados nos últimos 15 anos, ou antes, se pertinente. As informações recuperadas e selecionadas pela relevância foram usadas para analisar os critérios diagnósticos e propor um sistema diagnóstico incluindo critérios diagnósticos, anamnese, bem como exames complementares (neuroimagem e laboratório). Sempre que possível, os instrumentos foram selecionados com versões previamente adaptadas e validadas para uso no Brasil, segundo escolaridade e idade. Os protocolos propostos para exames complementares basearam-se no grau de prioridade, para aplicação na prática clínica ou em pesquisa.

Palavras-chave:
recomendações; demência vascular; critérios; neuroimagem; exames laboratoriais.

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Publication Dates

Publication in this collection
Oct-Dec 2011

History

Received
03 Sept 2011
Accepted
02 Nov 2011

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[1] Gauthier S, Rockwood K. Does vascular MCI progress at a different rate than does amnestic MCI? Int Psychogeriatr 2003;15(Suppl 1):257-259.

[2] Hachinski V. Vascular dementia: a radical redefinition. Dementia 1994;5:130-132.

[3] Ingles JL, Wentzel C, Fisk JD, Rockwood K. Neuropsychological predictors of incident dementia in patients with vascular cognitive impairment, without dementia. Stroke 2002;33:1999-2002.

[4] Loeb C. Clinical criteria for the diagnosis of vascular dementia. Eur Neurol 1988;28:87-92.

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