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Vascular Contributions to Cognitive Impairment
and Dementia (VCID) is proposed as a distinct
discipline on the stroke spec...
Years of follow-up
3,53,02,52,01,51,0,50,0
Dementia-freesurvival
100%
95%
90%
85%
no SBI
with SBI
HR (adj) =2.3
Dementia-f...
Vascular Contributions to Cognitive
Impairment & Dementia (VCID)
cardiac disease
micro-infarct
micro-bleed
small vessel is...
Co-Morbidities are the Norm in Dementia:
VCID is the Most Common Co-Morbidity
Attems and Jellinger, 2013, Neuropathology. ...
cardiac disease
micro-infarct
micro-bleed
small vessel ischemic stroke
silent stroke
small vessel hemorrhagic strokeCADASI...
Stroke AD Dementia
Stroke and AD Dementia:
Overlapping Fields
Stroke AD Dementia
VCID
Vascular Contributions to
Cognitive Impairment and
Dementia (VCID) as a Discipline
Stroke AD Dementia
VCID
Vascular Contributions to
Cognitive Impairment and
Dementia (VCID) as a Discipline
Cognitively Nor...
VCID Recognizes/Unifies the Biological Spectrum of
Vascular Contributions to Cognitive Impairment & Dementia
Sugar + Lipid...
 Congressional Task Force on Alzheimer’s (1999, US)
 Plan Alzheimer et Maladies Apparentées (2001-12, FR)
 Evaluation d...
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Alzforum Corriveau

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Leaky Blood-Brain Barrier a Harbinger of Alzheimer s Disease - presentation made at Alzforum's live webinar of February 17, 2015. See details at: http://www.alzforum.org/webinars/leaky-blood-brain-barrier-harbinger-alzheimers

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Alzforum Corriveau

  1. 1. Vascular Contributions to Cognitive Impairment and Dementia (VCID) is proposed as a distinct discipline on the stroke spectrum, closely related to and in part embedded in Alzheimer’s, that is scientifically and clinically poised for impact on disease burden. Proposal: Roderick A. Corriveau, Ph.D. Program Director, NINDS
  2. 2. Years of follow-up 3,53,02,52,01,51,0,50,0 Dementia-freesurvival 100% 95% 90% 85% no SBI with SBI HR (adj) =2.3 Dementia-freesurvival Vermeer, Breteler NEJM 2003;348:1215 (=21% of stroke-free individuals age 60-90) Years Follow-Up (Population-Based Imaging) Vermeer, Breteler NEJM 2003;348:1215 Decades of Studies Reveal Vascular Disease/Dementia links No Impairment Dementia Alzheimer alone 29% 42% Alzheimer + small strokes 8% 30% Schneider Ann Neurol 2009;66:200
  3. 3. Vascular Contributions to Cognitive Impairment & Dementia (VCID) cardiac disease micro-infarct micro-bleed small vessel ischemic stroke silent stroke small vessel hemorrhagic strokeCADASIL cerebral amyloid angiopathy (CAA) large vessel ischemic stroke TIA large vessel hemorrhagic stroke • VCID recognizes & unifies as a discipline the spectrum of Vascular Contributions to Cognitive Impairment & Dementia • VCID was historically siloed among disciplines with various names & inclusivity; scientific progress impacted • Separating VCI & dementia not advantageous for mechanisms focused research; e.g., a person may progress from VCI to dementia ~multi-infarct dementia ~vascular brain injury
  4. 4. Co-Morbidities are the Norm in Dementia: VCID is the Most Common Co-Morbidity Attems and Jellinger, 2013, Neuropathology. In: Dening T, Thomas A (eds) Oxford textbook of old age psychiatry, 2 edn., Oxford University Press., pp 87-105.
  5. 5. cardiac disease micro-infarct micro-bleed small vessel ischemic stroke silent stroke small vessel hemorrhagic strokeCADASIL cerebral amyloid angiopathy (CAA) large vessel ischemic stroke TIA large vessel hemorrhagic stroke • VCID recognizes & unifies as a discipline the spectrum of Vascular Contributions to Cognitive Impairment & Dementia • VCID includes & embraces its largely comorbid nature AD Pathology ~multi-infarct dementia ~vascular brain injury
  6. 6. Stroke AD Dementia Stroke and AD Dementia: Overlapping Fields
  7. 7. Stroke AD Dementia VCID Vascular Contributions to Cognitive Impairment and Dementia (VCID) as a Discipline
  8. 8. Stroke AD Dementia VCID Vascular Contributions to Cognitive Impairment and Dementia (VCID) as a Discipline Cognitively Normal Cognitive Impairment (e.g. MCI, VCI) Dementia
  9. 9. VCID Recognizes/Unifies the Biological Spectrum of Vascular Contributions to Cognitive Impairment & Dementia Sugar + Lipid Metabolism Immune Function AD Biology Stroke + Vascular Biology Neurovascular Unit
  10. 10.  Congressional Task Force on Alzheimer’s (1999, US)  Plan Alzheimer et Maladies Apparentées (2001-12, FR)  Evaluation du Plan Alzheimer 2013 «Elargir le champ du plan au-delà de la maladie d’Alzheimer»  England’s National Dementia Strategy (2009)  National Alzheimer’s Project Law (2011, US)  includes AD, vascular dementia, FTD, and LBD  2013: G8 Dementia Summit (London) VCID Poised as Distinct Scientific Discipline: International Recognition of the Relationship Between Dementia and the Vasculature

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