Behavioral and Psychological Symptoms in Vascular Cognitive Impairment

Abstract

AbstractSince the creation of the term “behavioral and psychological symptoms of dementia (BPSD)” by the International Psychogeriatric Association (IPA), new concept of this has advanced the understanding of behavioral disturbance and other neuropsychiatric symptoms in dementia. Cerebrovascular disease is known to be the second most common cause of acquired cognitive impairment including dementia. It is also presumed that cerebrovascular disease participates in cognitive decline of neurodegenerative dementia. It has been continuously recognized that various vascular pathologies can cause cognitive impairment or dementia. The term “vascular cognitive impairment” can cover all types of cognitive disorders, regardless of severity, which are associated with or attributed to cerebrovascular disease. Therefore, this term includes vascular cognitive impairment without dementia and vascular mild cognitive impairment primarily suspected of vascular basis. Characteristics and pathogenesis of the neuropsychiatric symptoms after stroke are thought to be significantly different from those of BPSD in vascular cognitive impairment. Neuropsychiatric symptoms that commonly occur after stroke include depression, apathy, anxiety, psychosis, catastrophic reaction, emotional lability or incontinence, and aggressiveness. Common neuropsychiatric symptoms that relatively frequently occur in vascular cognitive impairment are psychosis such as delusion or misidentification, depression, aggression/agitation, disinhibition, apathy, and anxiety. Consequently, based on the papers reported so far, we will review the differences between BPSD in vascular cognitive impairment and neuropsychiatric symptoms after stroke.