title: The early stage of vascular dementia: significance of a complete therapeutic program.
abstract: BACKGROUND
  Mild manifestations of vascular dementia are relatively widespread among the old-age population. Drug therapy for this disorder is insufficiently effective at present, making it necessary to improve the treatment of such patients by means of an adequate psychotherapeutic and rehabilitation program.
  
  
  OBJECTIVE
  To assess the role of psychotherapeutic and rehabilitation measures in improving outcome in the early stage of vascular dementia.
  
  
  METHODS
  The test and control cohorts (each n = 95) were matched for characteristics found to be significant for outcome of treatment (the relevant predictors were found using Multiple Regression Analysis). The cohorts differed in the amount of the psychotherapy and rehabilitation received. To assess the effects of treatment the SCAG scale and a special scale for evaluating the level of activity in the household were used.
  
  
  RESULTS
  In the test cohort the patients' condition improved significantly compared with the controls. Even in case of only slight therapeutic reduction of psychopathologic symptoms the systematic use of psychotherapeutic and rehabilitation methods favoured preserving a certain level of activity in the household and for some patients even improving it.
  
  
  CONCLUSIONS
  The results of therapy at the early stage of vascular dementia to a great extent depend on carrying out a full-scale psychotherapeutic and rehabilitation program. The positive significance of the latter is connected not only with improvement of clinical indices but also with direct optimizing the every day life activity level.
authors.affiliation: Department of Geriatric Psychiatry, St Petersburg, Russian Federation. levkruglov@yahoo.com
authors.forename: L S
authors.initials: LS
authors.lastname: Kruglov
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003131:Combined Modality Therapy; D015140:Dementia, Vascular / Q000188:drug therapy / Q000534:rehabilitation / Q000628:therapy*; D005196:Family Therapy; D006801:Humans; D011613:Psychotherapy / Q000379:methods*; D012044:Regression Analysis; D012944:Social Support; D016896:Treatment Outcome