title: [The characteristics of a comprehensive geriatric assessment in patients with mild cognitive impairment with a cerebral white matter lesion].
abstract: OBJECTIVE
  Vascular dementia may be referred to as "treatable dementia" because its development and progress can be inhibited by intervention in the early stage. In particular, cerebral white matter lesions are readily encountered the clinical setting. In this study, we aimed to clarify the phenomenon and symptoms of patients with mild cognitive impairment (MCI) with cerebral white matter lesions prior to the onset of dementia.
  
  
  METHODS
  The subjects included 181 cases diagnosed with MCI among 643 consecutive new patients of the Center for Comprehensive Care on Memory Disorder at Kyorin University Hospital from January 1, 2013 to January 31, 2014. Patients with particular diseases were excluded. An interview, physical examination, comprehensive geriatric assessment, brain MRI and SPECT were performed for all subjects. The cerebral white matter lesions were evaluated using the modified Fazekas scale. We defined Grades 0 and 1 as the group without apparent cerebral white matter lesions and Grades 2 and 3 as the group with apparent cerebral white matter lesions. We compared the laboratory findings and outcomes of these two groups.
  
  
  RESULTS
  The age of the group with apparent cerebral white matter lesions was significantly higher than the group without apparent cerebral white matter lesions (P<0.05). No significant difference was observed regarding gender, MMSE, or "vegetable" term retrieval. A significant difference was observed in the total score and the subordinate component of the 21-item fall risk index and geriatric depression scale between the groups (P<0.05). Additionally, a significant difference was observed regarding the subordinate component of the instrumental ADL, the Dementia Behavior Disturbance Scale and the Zarit Care Burden Scale between the groups (P<0.05).
  
  
  CONCLUSIONS
  Our results suggest that the presence of white matter lesions at the stage of MCI has a significant relationship to care burden due to the deterioration of ADL, risk of falling, and the presence of depression and behavior disorders. We speculate that our results are useful for the explanation of the characteristics of MCI with white matter lesion to the patients and the care givers. Furthermore, these results may lead to improvements in the appropriate approach, intervention and appropriate nursing of such patients.
authors.affiliation: Department of Geriatric Medicine, Kyorin University School of Medicine.
authors.forename: Toshimasa
authors.initials: T
authors.lastname: Obara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hasegawa
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Wachi
authors.forename: Masamichi
authors.initials: M
authors.lastname: Tanaka
authors.forename: Michiko
authors.initials: M
authors.lastname: Sato
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Hitomi
authors.initials: H
authors.lastname: Koshiba
authors.forename: Kumiko
authors.initials: K
authors.lastname: Nagai
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Yamada
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Matsui
authors.forename: Koichi
authors.initials: K
authors.lastname: Kozaki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D060825:Cognitive Dysfunction / Q000473:pathology*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D011795:Surveys and Questionnaires; D066127:White Matter / Q000473:pathology*