Background: Vascular cognitive impairment (VCI) is poised to become the silent epidemic of the 21st century and contribute significantly to mortality, disability, and decreased quality of life.                                             .

Aim: To investigate the frequency and clinical determinants of vascular dementia (VD) and Vascular mild cognitive impairment (VMCI) following ischemic stroke. The one year follow-up was done to assess the prognosis.    

 Materials and Methods: A prospective study was conducted among 100 consecutive patients aged ≥40 years with the diagnosis of ischemic stroke within previous 2 - 3 months. The subjects were be subjected to structured medical and neurological history based on review of all available hospital charts, interview of the subject and a knowledgeable informant, and a structured clinical, neurological, neuropsychological, and neuroradiological evaluation. Patients will be retested at 3, 6, and 12 months after stroke.                                                          .

Results: 60% of stroke patients were diagnosed as VCI. 23 subjects were diagnosed as VD. The prevalence of VMCI was 37% and forty percent of the patients had no cognitive impairment. An annual conversion rate from ‘VMCI’ to ‘VD was 8%. The annual rate of deterioration from ‘No Cognitive Impairment’ to ‘VMCI’ was 10% .

Conclusion: This study supports the high prevalence of dementia and mild cognitive impairment following stroke, especially in older individuals, and highlights the importance of cognitive reserve.                                .

Keywords: Ischemic stroke, vascular dementia, Vascular cognitive impairment, Vascular mild cognitive impairment.                                       

1. Hachinski VC, Bowler JV. Vascular dementia: Diagnostic criteria for research studies. Neurology 1993;43:2159-60.
2. Tatemichi TK, Foulkes MA, Mohr JP, Hewitt JR, Hier DB, Price TR, et al. Dementia in stroke survivors in the Stroke Data Bank cohort. Prevalence, incidence, risk factors, and computed tomographic findings. Stroke 1990;21(6):858–66.
3. Ivan CS, Seshadri S, Beiser A, Au R, Kase CS, Kelly-Hayes M, Wolf PA: Dementia after stroke: the Framingham Study: Stroke 2004; 35: 1264–1269.
4. Tatemichi TK, Desmond DW, Paik M, Gropen TI, Stern Y, Sano M, Remien R, Williams JBW, Mohr JP, Mayeux R: Clinical determinants of dementia related to stroke. Ann Neurol 1993; 33: 568–575.
5. Desmond DW, Moroney JT, Paik MC, Sano M, Mohr JP, Aboumatar S, Tseng C-L, Chan S, Williams JBW, Remien RH, Hauser WA, Stern Y: Frequency and clinical determinants of dementia after ischemic stroke. Neurology 2000;54: 1124–1131
6. Pohjasvaara T, Erkinjuntti T, Ylikoski R, Hietanen M, Vataja R, Kaste M: Clinical determinants of poststroke dementia. Stroke 1998; 29: 75–81.
7. Ivan CS, Seshadri S, Beiser A, Au R, Kase CS, Kelly-Hayes M, Wolf PA: Dementia after stroke: the Framingham Study: Stroke 2004; 35: 1264–1269.
8. American Psychiatric Association: Diagnostic and statistical manual of mental disorders, 4^th Washington: American Psychiatric Association, 1994.
9. Chui HC, Victoroff JI, Margolin D, Jagust W, Shankle R, Katzman R: Criteria for the diagnosis of ischemic vascular dementia proposed by the State of California Alzheimer’s Disease Diagnostic and Treatment Centres. Neurology 1992; 42: 473–480.
10. Pohjasvaara T, Erkinjuntti T, Ylikoski R, Hietanen M, Vataja R, Kaste M: Clinical determinants of poststroke dementia. Stroke 1998; 29: 75–81.
11. Ladurner G, Iliff LD, Lechner H: Clinical factors associated with dementia in ischemic stroke. J NeurolNeurosurg Psychiatry 1982; 45.
12. Pohjasvaara T, Vataja R, Leppavuori A, Erkinjuntti T: Dementia poststroke. Psychogeriatrics 2001; 1: 88–99.
13. Wentzel C, Rockwood K, MacKnight C, Hachinski V, Hogan DB, Feldman H, et al. Progression of impairment in patients with vascular cognitive impairment. Neurology 2001:28; 57(4):714– 6.
14. Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E. Mild cogni-tive impairment: clinical characterization and outcome.ArchNeurol 1999;56:303– 8.
15. Ritchie K, Touchon J. Mild cognitive impairment: conceptual basis and current nosological status. Lancet 2000;355:225– 8.

Murugapandian Nagarajan

Senior Assistant Professor of Neurology,

Govt. Kilpauk Medical College, Chennai-10, India

Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Tel:+91-9443921569