The subclinical atherosclerosis can change the risk of cerebrovascular disease?

Abstract

Revista HUPE, Rio de Janeiro, 2013;12(Supl 1):36-43

doi: 10.12957/rhupe.2013.7081

The scientific literature has recognized that cerebrovascular disease can cause severe cognitive deficits. The entity of vascular dementia is best understood as a heterogeneous syndrome than a distinct disorder.  Worldwide, nearly 35.6 million people live with dementia. This number is expected to double in 2030. World Health Organization recognizes dementia as a public health priority. Stroke remains the number one cause of disability and the third cause of death in USA. One in three Americans will have a stroke or develop dementia in their lifetime. The prevalence of Alzheimer disease doubles every 4.3 years and that of vascular dementia doubles every 5.3 years. Dementia is one of the major causes of disability and dependency among older people worldwide. It is overwhelming not only for the people who have it, but also for their caregivers and family. There is substantial evidence, despite controversial issues, from observational studies and clinical trials that conventional risk factors such hypertension, diabetes, dyslipidemia, smoking, atrial fibrillation and life style, for example, play a role in the development of cognitive impairment and dementia. This is a field in need of research because further decline in cognition might be preventable in the early stages. Unfortunately, although we now know much about individual risk factor for dementia, we do not know how they interact or which risk factors account for what proportion of dementia cases and which specific interventions can lower this risk. Future research is needed to clarify the role of risk factors modification in limiting vascular brain injury to prevent vascular cognitive impairment and dementia.

Keywords: Atherosclerosis; Risk factors; Cerebrovascular disease; Stroke; Dementia.