John F Kennedy University, California, USA
Posters & Accepted Abstracts: J Neurol Neurophysiol
Vascular dementia (VaD) is a highly complex disease process characterized by multiple pathogenic processes and disease pathways, heterogeneous symptom presentation and bidirectional interactions with other forms of dementia. Addressing populationbased impacts of vascular disease can increase life span and overall wellbeing, while improving community health and reducing the financial and resource burden on care delivery systems. An effective population-based response to the impact of VaD and its role in other forms of cognitive decline should incorporate assessment, interventions and treatment pathways adapted for key primary, secondary and tertiary prevention targets for vascular disease and its comorbidities. VaD is associated with pathogenic processes that can lead to the classical symptoms characterized by the classic step-wise decline in functioning (e.g., multi-infarct dementia), as well as pathology that enhances a steady decline of cognitive, affective and behavioral functioning, in line with the symptomology of other forms of dementia (e.g., microbleeds and microinfarcts). Vascular disease also exhibits direct neuroplastic impacts that can lead to reduced neurogenesis, degradation in or poor repair of myelin sheaths, decline in synaptogenesis, apoptotic cascades and impacts of the neuro-immune regulators on brain plasticity. While incidents of isolated VaD are less common then Alzheimer├ó┬?┬?s dementia, prevalence of vascular disease is high, increasing the risk for cognitive impairment in other progressive dementing processes. It is likely that vascular disease exacerbates the symptoms and risk of transition between mild cognitive impairment and other forms of dementia. VaD has a profound effect on health care costs, communities, individual health, family health and systems of care. This presentation will explore the development of an integrated biopsychosocial systems-based approach to population health improvement, achieved by developing key assessments, treatments and pathways of care aimed at primary, secondary and tertiary prevention of vascular dementia and its impacts on other forms of cognitive decline.