1990 Fiscal Year Final Research Report Summary
Epidemiological and Physiological Study of Vascular Dementia in a General Population.
| Project/Area Number |
01440039
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| Research Category |
Grant-in-Aid for General Scientific Research (A)
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| Allocation Type | Single-year Grants |
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| Research Field |
内科学一般
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| Research Institution | Kyushu University |
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Principal Investigator |
FUJISHIMA Masatoshi Kyushu University, Faculty of Medicine Professor., 医学部, 教授 (80038760)
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| Co-Investigator(Kenkyū-buntansha) |
IBAYASHI Seturou Kyushu University, Faculty of Medicine Assistant., 医学部, 助手 (40213201)
KIYOHARA Yutaka Kyushu University, Faculty of Medicine Assistant., 医学部, 助手 (80161602)
HASUO Yutaka Kyushu University, Faculty of Medicine Assistant., 医学部, 助手 (50180849)
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| Project Period (FY) |
1989 – 1990
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| Keywords | Vascular dementia / Senile dementia of Alzheimer's type / Epidemiology / Gemeral population / Cerebral blood flow / Metabolism |
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| Research Abstract |
The prevalence of dementia was studied in 887 males and females Hisayama residents aged 65 or over (screening rate, 94.6%) using clinical information, neurological examination and dementia scales. We found 59 cases with dementia, the prevalence being 6.7% of the screening population with females predominant. Vascular dementia was more frequent, with the ratio of vascular dementia to senile dementia of Alzheimer's type being 4.5 for males and 1.2 for females. Brain-pathology in 47 cases with dementia out of 59 was examined by CT scan or at autopsy during the subsequent 20-month period. Based onhe morphologic diagnoses, vascular dementia was high in frequency at 55% of the demented cases, being three times higher than senile dementia of Alzheimer's type. Follow-up studies revealed that the patients with dementia survived poorly than nondemented controls. Survival rate of the cases with vacular dementia was better than the cases with senile dementia of Alzheimer's type.
We also performed clinical and neuroradiologic studies, including positron emission tomography, in five patients with vascular dementia of the Binswanger type. The clinical features of these cases consisted of slowly progressive dementia, together with vascular risk factors such as hypertension and often a history of minor stroke, and characteristic white matter lesions on brain computed tomograms or magnetic images. Both cerebral blood flow and the cerebral metabolic rate for oxygen were markedly reduced in the white matter (54 - 77% of control values), and both were decreased in the parietal(73% of control), frontal (74 - 80%), and temporal (74 - 83%) cortices, where no abnormalities were detected by brain computed tomography or magnetic resonance imaging. We conclude that vascular dementia of the Binswanger type may be caused by disconnection between the cerebral cortex and subcortical structures due to ischemic damage in the white matter.
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