Cognitive-Functional Interaction in Patients with Vascular Dementia

Abstract

Background: There is a close interaction between cognitive and functional performance in the normal brain. It increases in cases of brain disease, where a worse initial cognitive performance is associated with subsequent functional decline. Objective: To describe the cognitive and functional performance profile and their interaction in a population of patients with Vascular Dementia (VD). Methods: We studied 79 patients (Group 1, G1) with VD and 80 healthy subjects without brain disease (Group 2, G2). The following tests were administered to all the study population: ADAS Cog., Trail Making Test (TMT), Mini Mental State Examination (MMSE), Basic and instrumental activities of daily living (ADL, IADL), Disability Assessment for Dementia (DAD), and Gottfries-Brane-Steen Scale (GBS). Scores were statistically evaluated usingthe ANOVA Test, Spearman’s correlation matrix and Principal Component Analysis (PCA). Results: The average age of G1 was 72.6 + 7.1 and their literacy level was 8.05 + 4.76 years. The cognitive profile showed a significant global decline in the MMSE (19.9 + 3.77 points) and in the ADAS Cog (29.2 + 8.80 points). In this group, the cognitive functions most compromised were Memory, Orientation and Recognition and, to a lesser degree, Attention, Language and Praxis. The functional profile showed the greatest impairment in IADL. The PCA showed a correlation of ADAS with TMT and Katz Index, and of MMSE and DAD. Conclusions: The results highlight the interaction between complex functional performance and cognition, suggesting an impact of cognitive impairments linked to executive function on functional performance, of potential therapeutic significance.