Sally Gilmour
The Meadows Hospital-Stockport Pennine Care NHS Trust, UK
Title: The 2018 Stockport vascular neuro cognitive disorder investigation, treatment and annual review guidelines (Including the spectrum from mild vascular cognitive impairment to vascular dementia) supporting primary and secondary care physicians
Biography
Biography: Sally Gilmour
Abstract
Vascular NeuroCognitive Disorder patients may already be receiving adequate treatment for other cardiovascular disease, but we should reassess ensuring optimum Secondary Cardiovascular Risk Prevention with New Location Target End Organ Damage. A minority are not receiving secondary cardiovascular prevention as Vascular NeuroCognitive Disorder is their first diagnosis of cardiovascular system disease. Many of these newly diagnosed patients may not subsequently receive secondary cardiovascular risk prevention perhaps especially with sub cortical gradual reduction in activities of daily living and change to personality .There is no research evidence to treat Cerebrovascular disease which is proportional to that expected for the patient age on MRI or CT brain. The MRI Fazekas score should reflect the clinical indication of Brain Target Organ Vascular Disease more so than expected age related change. Gradient Echo assesses micro haemorrhage which may mean anti platelets or anticoagulants are contra-indicated, prevalent in Cerebral Amyloid Angiopathy and mixed Vascular and Alzheimer’s pathology. Patient Treatment advice leaflets assist informed shared decisions; although there is no consensus from research evidence that treating blood pressure, cholesterol and using anti platelets or anti coagulation will reduce cognitive decline in vascular NeuroCognitive disorder, there is evidence for secondary cardiovascular prevention once there is diagnosis of target organ damage to the brain with vascular pathological Brain Target Damage. Risk consideration assesses patients and carers, SIGNPOST to healthy lifestyle advocated by Lancet 2017 Dementia Commission. Vascular NeuroCognitive disorder support and healthy lifestyle published leaflets examples include ‘4ME’.