Neuropsychiatric manifestations in vascular cognitive impairment patients with and without dementia.

BACKGROUND: Neuropsychiatric profile has less been well recognized in all subtypes of vascular cognitive impairment (VCI). The aim of this study is to explore the neuropsychiatric manifestations in patients with different subtypes of VCI.

METHODS: A consecutive series of 157 patients with VCI visited the dementia clinic in a regional hospital in mid-Taiwan were investigated in this study. All patients were examined with the Cognitive Abilities Screening Instrument (CASI), the Hachinski's Ischemic Scale (HIS), and the Clinical Dementia Rating (CDR) scale. The Neuropsychiatric Inventory (NPI) was used to assess neuropsychiatric symptoms.

RESULTS: Of the 157 participants with VCI, 41 (26.1%) had VCI, without dementia (vascular CIND), 95 (60.5%) had vascular dementia (VaD), 21 (13.4%) had Alzheimer's disease (AD) with a vascular component (mixed AD/VaD). Sleep disturbance was the most common symptom in all patient groups. Apathy is significantly lower in VCI without dementia compared with VCI with dementia. Patients with VaD had the highest mean composite NPI scores in most domains and vascular CIND patients had the lowest composite scores in most domains.

CONCLUSIONS: Neuropsychiatric symptoms were common in patients with VCI with and without dementia. It deserves attention that neuropsychiatric symptoms as well as cognitive deficits frequently arise from cerebrovascular disease regardless of the development of dementia.