title: The Florence VAS-COG clinic: a model for the care of patients with cognitive and behavioral disturbances consequent to cerebrovascular diseases.
abstract: OBJECTIVE
  Services dedicated to patients with cognitive and behavioral consequences of cerebrovascular diseases are not well established. In this paper, we report on the general organization of such a service (the Florence VAS-COG Clinic) after 9 years of activity, updating a previous work related to the first 5 years.
  
  
  METHODS
  The Florence VAS-COG clinic, started in 2006, is an outpatient service dedicated to the assessment and follow-up of patients with cerebrovascular diseases and related cognitive, psychiatric, and behavioral disturbances. The staff involved in the clinic is composed of certified neurologists, one neuropsychologist, and neurology residents. The diagnostic protocol includes detailed personal and family history, general and neurologic examinations, and functional, neuropsychological, and neuroimaging assessment. After this work-up, comprehensive diagnoses are made.
  
  
  RESULTS
  From January 2006 to March 2014, 600 patients (mean age 67.3 years ± 13.9; 52% females) have been evaluated in the clinic. Cognitive impairment, including mild cognitive impairment and dementia, mainly of vascular origin, was the most common (36.4%) diagnostic category, followed by suspected or confirmed familial micro-angiopathy (35.8%). Compared to the first years of activity, we are now facing the need of augmenting the number of visits due to increasing request and to better implement the multidisciplinarity of the team. Efforts are currently directed towards the definition of management protocols in pharmacological and non-pharmacological strategies.
  
  
  CONCLUSIONS
  The establishment of a VAS-COG clinic represents an important step for the appreciation of the patient clinical needs and for the implementation of screening, diagnostic, and treatment options in the field of the neuropsychiatric consequences of cerebrovascular diseases.
authors.affiliation: NEUROFARBA Department, Neuroscience section, University of Florence, Florence, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Poggesi
authors.affiliation: NEUROFARBA Department, Neuroscience section, University of Florence, Florence, Italy.
authors.forename: Emilia
authors.initials: E
authors.lastname: Salvadori
authors.affiliation: NEUROFARBA Department, Neuroscience section, University of Florence, Florence, Italy.
authors.forename: Raffaella
authors.initials: R
authors.lastname: Valenti
authors.affiliation: NEUROFARBA Department, Neuroscience section, University of Florence, Florence, Italy.
authors.forename: Serena
authors.initials: S
authors.lastname: Nannucci
authors.affiliation: NEUROFARBA Department, Neuroscience section, University of Florence, Florence, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Ciolli
authors.affiliation: Stroke Unit and Neurology, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Pescini
authors.affiliation: NEUROFARBA Department, Neuroscience section, University of Florence, Florence, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Pasi
authors.affiliation: NEUROFARBA Department, Neuroscience section, University of Florence, Florence, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Fierini
authors.affiliation: NEUROFARBA Department, Neuroscience section, University of Florence, Florence, Italy.
authors.forename: Ida
authors.initials: I
authors.lastname: Donnini
authors.affiliation: NEUROFARBA Department, Neuroscience section, University of Florence, Florence, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Marini
authors.affiliation: NEUROFARBA Department, Neuroscience section, University of Florence, Florence, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: Chiti
authors.affiliation: NEUROFARBA Department, Neuroscience section, University of Florence, Florence, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Rinnoci
authors.affiliation: NEUROFARBA Department, Neuroscience section, University of Florence, Florence, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Inzitari
authors.affiliation: Stroke Unit and Neurology, Azienda Ospedaliero Universitaria Careggi, Florence, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Pantoni
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities; D001526:Behavioral Symptoms / Q000209:etiology* / Q000628:therapy; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000453:epidemiology; D003072:Cognition Disorders / Q000209:etiology* / Q000628:therapy; D005260:Female; D006801:Humans; D007558:Italy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D059906:Neuroimaging; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D012189:Retrospective Studies; D055815:Young Adult
keywords: Dementia; mild cognitive impairment; outpatient clinic; post-stroke aphasia; post-stroke depression; small vessel disease; stroke; vascular cognitive impairment