Pattern of cognitive deficit in vascular dementia

Abstract

Background: Vascular dementia (VaD) is the second most common cause of dementia after Alzheimer’s disease. Vascular dementia has heteregeneous manifestation due to varying infarct location and subtypes. Despite quite frequent in Indonesia due to high incidence of stroke, the study about pattern of cognitive deficit in vascular dementia are still limited.

Methods: This study is an observational cross-sectional consecutive sampling study conducted at the Memory Clinic of Provincial General Hospital Prof. Dr. R.D.Kandou, Manado, North Sulawesi, Indonesia during the period 1 January 2023 to 31 March 2024. Vascular dementia was diagnosed based on NINDS-AIREN criteria, and further classified based on Vascular Impairment of Cognition Classification Consensus Study (VICCCS). Cognitive examinations were done by using the Indonesian version of the Montreal Cognitive Assessment instrument (MoCA- INA) and other cognitive examinations.

Results: There were 100 subjects who met the inclusion and exclusion criteria. The mean MoCA-INA in the study subjects was 12.2 (SD ± 6.0), with the lowest value found in mixed type dementia followed by multiple infarction/cortical and subcortical vascular dementia. Memory was the domain that most frequently impaired in vascular dementia. Impairments in the language domain were more common in the multiple infarct/cortical subtype, while executive function deficits were more frequently found in the subcortical subtype of vascular dementia (p<0.001). Attention, memory and visuospatial disorders did not show any significant differences in the three subtypes of vascular dementia.

Conclusion: Language disorders are more common in multiple infarction or cortical subtypes, while executive function is more dominantly impaired in the cortical subtype.