Cognitive and neurologic predictors of functional impairment in vascular dementia.
OBJECTIVE
The purpose of this study is to investigate associations between executive dysfunction, neuroimaging findings, and functional impairment in patients with vascular dementia (VaD).


METHODS
Twenty-nine VaD patients completed the Dementia Rating Scale and underwent MRI scanning to generate quantitative ratings of subcortical hyperintensities (SH) and cortical volume. Patients' caregivers completed items from the Lawton and Brody Activities of Daily Living Questionnaire, designed to measure instrumental activities of daily living (IADLs). The authors hypothesized that performance on the Initiation/Perseveration (IP) subscale, a measure of executive abilities, and SH would significantly predict levels of IADLs.


RESULTS
A hierarchical multiple-regression analysis revealed that IP and SH accounted for 42% of the variance in IADLs; IP alone accounted for 28%, and SH accounted for 14% beyond the contribution made by IP.


CONCLUSIONS
Findings indicate that specific cognitive and neuropathological factors are associated with functional impairment in VaD.
Boyle
Patricia A
PA
Department of Psychiatry, Brown Medical School, Providence, RI 02912, USA. pboyle@lifespan.org
Paul
R
R
Moser
D
D
Zawacki
T
T
Gordon
N
N
Cohen
R
R
D000203:Activities of Daily Living; D000368:Aged; D001921:Brain / Q000473:pathology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015140:Dementia, Vascular / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011795:Surveys and Questionnaires