Clinical and neuropsychological features of Alzheimer's disease in the combination with cerebrovascular disease

Abstract

To study clinical/neuropsychological and neuroimaging characteristics of Alzheimer's disease in the combination with cerebrovascular disease (CVD). Ninety patients with dementia, including 35 patients with AD, 35 patients with mixed dementia (MD) and 20 patients with vascular dementia, were examined. The character of dementia was established according to NINCDS-ADRDA and NINDS-AIREN criteria. The neuropsychological battery included Addenbrooke's Cognitive Examination (ACE-R), Montreal Cognitive Assessment scale (MoCA), fluency test and the visual memory test (SCT). Affective and behavioral disorders were assessed with the Cornell Depression Scale in patients with dementia and a short version of NPI-4 in AD patients. Focal and diffuse changes were assessed with MRI. Patients with MD were older, had more often pseudobulbar syndrome (74%), postural instability (66%), frontal gait disorders (57%), Neuropsychological profile of patients with MD had mixed amnestic-dysexecutive character and, depending on the severity of vascular pathology, was closer to AD or to vascular dementia. Neuroimaging changes of patients with MD were correlated with clinical manifestations. The authors propose the approaches to the differential diagnosis of MD that allow to determine the main directions of treatment more precisely and to predict disease course.