Clinical Features Of The Patients With Vascular Cognitive Impairment-no Dementia With Subcortical Small Vessel Disease

[Objective] To assess the cognitive profile of vascular cognitive impairment-no dementia with subcortical small vessel disease (VCIND-SSVD) patients using a set of cognitive measures, and develop neuropsychological tests for VCIND-SSVD patients.[Methods] Extensive neuropsychological tests including MMSE and covering 5 cognitive domains were performed on 59 VCIND-SSVD patients and 40 normal control subjects. Impaired cognitive domains in each patient were determined. The suitable discriminating single-item tests were selected, and the discriminating validity of the individual tests was explored.[Results] Compared with the normal control group, VCIND-SSVD patients exhibited impairment in multiple domains which include memory, attention, language function, visuospatial function and executive function (P<0.05). Using the Chinese version of the Wechsler Adult Intelligence Test (WAIS-RC), the receiver operating characteristic curve (ROC) showed good sensitivity and specificity for the Immediate Logical Memory Test, Block-Building Test, and the completion time and planning time of the Tower of London Test, which formed a comprehensive assessment tool for the VCIND-SSVD patients.[Conclusions] The selected tests showed good discriminating capability in detecting VCIND-SSVD patients, and could be clinically important.Partâ…¡Influence of nutritional status on cognitive and functional deficits in vascular cognitive impairment-no dementia with subcortical small vessel diseasepatients[Objective] To explore the risk factors of vascular cognitive impairment-no dementia with subcortical small vessel disease (VCIND-SSVD), and investigate the role of nutritional status on cognitive and functional deficits in patients with VCIND-SSVD. [Methods] Fifty-nine VCIND-SSVD patients underwent disease-history survey, physical examinations, neuroradiological examinations, laboratory tests, neuropsychological assessments, and nutritional and daily-living activity assessments. The patients were divided into at-risk for malnutrition group (34 patients) and well-nourished group (25 patients) according to the Mini Nutritional Assessment (MNA) score.[Results] There were statistically significant differences in hypertension, history of stroke, homocysteien, folic acid and VitminB12 between the VCIND-SSVD patients and the normal control subjects (P<0.05). The two cohorts were similar for neuropsychological assessments (P>0.05). Patients at-risk for malnutrition showed greater impairment in daily-living activities (P<0.05). Multiple logistic regression showed a significant association between the nutritional status and daily-living activities of VCIND-SSVD patients. Nutritional state was an important clinical variable in predicting the impairment of VCIND-SSVD patients in ADL (OR=0.75) and in IADL scores (OR=0.44).[Conclusions] Hypertension, history of stroke, homocysteien, low Serum foliate and VitaminB12 levels increase the risk of VCIND-SSVD. The nutritional status is significantly associated with daily-living activities in VCIND-SSVD patients. MNA scale has important practical values in evaluating nutritional status within VCIND-SSVD patients.