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New Guidelines for Improving Research into Vascular Dementia

by Dr. Meenakshy Varier on Jan 19 2017 1:39 PM
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Highlights

  • Up until now, the research in to vascular cognitive impairment (VCI) has been relatively uncommon and insufficient.
  • Insufficiency has affected the prevalence estimates, clinical diagnosis rates and treatment of VCI.
  • The new study provides guidelines for clearer diagnosis and also to simplify the eligibility for people to take part in specific research studies on VCI.
New guidelines that will help to progress research into vascular cognitive impairment (VCI) have been developed.
The study which brought together the views of over 150 researchers in 27 countries was led by academics at the University of Bristol.

So far, the research on VCI have been relatively less common than other types of dementia and cognitive impairment.

Though numerous diagnostic criteria, from previous research, have tried to trace the differences in clinical manifestations and diagnosis of vascular cognitive impairment (VCI), none have been universally accepted.

These criteria have not been readily comparable, impacting the clinical diagnosis rates, prevalence estimates, research, and treatment.

Vascular Cognitive Impairment-(VCI)

VCI refers to a decline in mental abilities, such as memory, thinking and planning, caused by problems that reduce or block the blood supply to the brain.

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This can deprive the brain cells of vital nutrients and oxygen. VCI maybe mild or severe depending on the symptoms. The milder form is referred to as mild cognitive impairment.

The more severe form of VCI is vascular dementia.

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VCI is the second most common cause of dementia and gradual memory loss after Alzheimer's disease and there is no cure for either.

Vascular dementia is a common form of dementia that is estimated to affect more than 135,000 people in the UK. It contributes to the largest cause of death in England and Wales according to recent reports.

Early warning signs of vascular dementia including slowness of thought, difficulty with planning, trouble with language, problems with attention and concentration, mood or behavioral changes.

Project

The Bristol team, led by Pat Kehoe, Gestetner Professor of Translational Dementia Research and Joint Head of the Dementia Research Group in the School of Clinical Sciences, invited researchers from around the world to participate in a project called the Vascular Impairment of Cognition Classification Consensus Study (VICCCS), which is funded by the Alzheimer's Society.

Professor Pat Kehoe, Chief Investigator for the study, said "It may seem somewhat simplistic to some people that this study has been to get people to agree on how to view and name conditions that affects as many as 100,000 people in the UK alone."

"However, more than 20 years of research has been significantly hampered because numerous studies looked at this complicated group of related conditions in a large number of ways and under numerous different names. This has made the interpretation of any findings with other studies extremely difficult. For the field to move forward, and for us to successfully test potential therapies, there is a need for much greater clarity so that studies can be designed appropriately and meet with the latest requirements from regulatory bodies." Kehoe adds.

The project made use of an online consensus-building technique that uses recurring surveys, known as the Delphi method.

The study was conducted in two parts and identified and addressed the issues from the last two decades that have obstructed the progression of VCI research.

These surveys addressed issues and came up with consensus agreements that involved six phases of surveys over approximately two. The issues addressed were:
  • what should be the guiding principles in defining a modern and workable concept of VCI .
  • how the diagnosis of these conditions can be made in a more standardized way across the world.
Dr Olivia Skrobot, Research Associate in the School of Clinical Sciences, who coordinated the study, added "This study was designed as a means to overcome the historical barriers to advance this area of research. The involvement of so many international researchers will, we hope, promote a new level of collaboration and togetherness and encourage significant progress for VCI research."

Dr Doug Brown, Director of Research and Development at Alzheimer's Society said, "Research relies on collaboration between experts in order to pool knowledge to further our understanding of the causes of health conditions and how to treat them. This research will allow us to work from the same understanding and criteria which will significantly speed up research in this vital area."

Conclusion

The paper, published in Alzheimer's & Dementia: The Journal of the Alzheimer's Association, describes the results of the first part of the VICCCS project.

The aim of this part of the study is to provide guidelines for clearer diagnosis and also to simplify the eligibility for people to take part in specific research studies on VCI.

The second part of the project which deals with challenges around diagnostic approaches and lack of standardisation, is being prepared for publication.

As dementia is now the biggest killer in the UK, the researchers need to bring the much-needed help to people with this condition as quickly as possible.

References

  1. Vascular dementia - (http://www.nhs.uk/Conditions/vascular-dementia/Pages/Introduction.aspx)
  2. Pat Kehoe et al. The Vascular Impairment of Cognition Classification Consensus Study (VICCCS). Alzheimer's & Dementia: The Journal of the Alzheimer's Association ; (2017) doi.org/10.1016/j.jalz.2016.10.007


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