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Cognitive test performances were correlated prospectively with changes in cerebral CT measurements of atrophy,infarct volume,ventricular enlargement,local tissue density,and local perfusion to contrast annual rates of change among patients with ischemic vascular dementia(IVD)or dementia of the Alzheimer type(DAT).In IVD,recurrent strokes were not observed clinically during risk factor control,and antiplatelet therapy and cognitive impairments improved or stabilized.In DAT,cognitive performance relentlessly declined.Ischemic pathogenesis for vascular dementia is supported by the following:(1)strokes,and(2)bidirectional cognitive changes correlate directly with frontal white matter,thalamic, and internal capsular perfusional changes. |
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