George P Paraskevas1*, Elisabeth Kapaki1, Vasilios C Constantinides1, George Liakakis1, Ilia Theotoka1, Panagiotis G Paraskevas2, Ioannis Zalonis1
1Department of Medicine, National and Kapodistrian University of Athens, Greece
2Department of Nursing, School of Health and Welfare Services, Technological Educational Institute of Crete, Greece
*Corresponding Author: George P Paraskevas, Division of Cognitive and Movement Disorders and Unit of Neurochemistry and Biological Markers, 1st Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Eginition Hospital, 72 Vas. Sophias Ave, Athens 11528, Greece.
Received: Aug 16, 2019
Published: Sep 6, 2019
Vascular cognitive disorder (VCD)2 comprises a heterogeneous group of cerebrovascular disorders, leading to a continuum of cognitive impairment, ranging from the level of mild cognitive impairment or mild vascular cognitive disorder (VCDM) to full-blown vascular dementia or major vascular cognitive disorder (VCDD). The Mattis Dementia Rating Scale-Initiation Perseveration subscale (MDRS-IP) may be useful for the assessment of frontal dysfunction, which is significantly affected in most patients with VCD. The aim of the present study was to explore the diagnostic value of MDRS-IP in patients with VCD of various severity. In a total of 140 patients fulfilling most recent criteria for VCDD and VCDM or having cerebrovascular disease with no clinically obvious cognitive decline (vascular controls, VC) and 15 healthy controls (Ctrl) we administered the Mini Mental State Examination (MMSE) and the MDRS-IP. Both MMSE and MDRS-IP perform better at the dementia level of VCD (VCDD), being effective in the discrimination of vascular dementia from the Ctrl or VC groups. However, in patients with VCDM, MMSE and MDRS-IP have statistically significant, but clinically moderate ability to differentiate from Ctrl or VC, i.e., to identify cognitive dysfunction in early, pre-dementia stages. Finally, both tests failed in the discrimination between VC and Ctrl, indicating that they are not sensitive enough to identify patients with cerebrovascular disease and subclinical cognitive dysfunction.
Keywords: Vascular cognitive disorder, Vascular cognitive impairment, Vascular dementia, Mattis dementia rating scale, Initiation and perseveration subscale, Neuropsychological testing