Nav: Home

New guidelines could help improve research into vascular cognitive impairment

January 16, 2017

New guidelines have been developed that it is hoped will help to progress research into vascular cognitive impairment (VCI) following a study led by academics at the University of Bristol that brought together the views of over 150 researchers in 27 countries.

VCI refers to a decline in mental abilities, such as memory, thinking and planning, caused by problems with the blood supply to the brain. Vascular dementia, which is perhaps a more familiar term to most people, is recognised as a severe form of VCI. VCI is the second most common cause of dementia and gradual memory loss after Alzheimer's disease. Like Alzheimer's disease it does not have a cure and together both conditions contribute to the largest cause of death in England and Wales according to recent reports.

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.

The international consortium has published their findings on what was agreed as a revised conceptual model of VCI and what should be considered to be its various subtypes. This new concept has built upon some key elements from sets of criteria that have been previously proposed but adopted to varying degrees. This lack of widespread adoption of any single criteria before now has proved to be a major stumbling block towards any progress in VCI research.

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."

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 issues from the last two decades that have obstructed the progression of VCI research, which lags noticeably behind that of Alzheimer's disease.

Firstly, the surveys addressed what should be the guiding principles in defining a modern and workable concept of VCI and secondly, how the diagnosis of these conditions can be made in a more standardised way across the world. These surveys addressed issues and came up with consensus agreements in a step-by-step repetitive method that involved six phases of surveys over approximately two years.

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: "Alzheimer's Society is thrilled to have funded this research as these guidelines will provide essential help to streamline research into vascular dementia. Historically, research in this area has lagged behind researchers' knowledge of Alzheimer's disease, despite vascular dementia being the second most common cause of the condition."

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

The paper, published in Alzheimer's & Dementia: The Journal of the Alzheimer's Association, describes the results of the first part of VICCCS, and the researchers hope the revised model of VCI will be widely adopted by the field. The team is currently preparing the second part of their findings from the study for publication, where challenges around diagnostic approaches and lack of standardisation have been addressed.

The aim of this part of the study is to provide guidelines to enable clearer diagnosis and also to simplify the eligibility for people to take part in specific research studies on VCI that have been relatively less common than other types of dementia and cognitive impairment.
-end-
Paper: 'The Vascular Impairment of Cognition Classification Consensus Study (VICCCS)' by Olivia A Skrobot et al in Alzheimer's & Dementia.

University of Bristol

Related Dementia Articles:

Flies the key to studying the causes of dementia
A research team from the University of Plymouth, University of Southampton and the Alexander Fleming Biomedical Sciences Research Center, Vari, Greece, have studied two structurally-similar proteins in the adult brain and have found that they play distinct roles in the development of dementia.
Stroke prevention may also reduce dementia
Ontario's stroke prevention strategy appears to have had an unexpected, beneficial side effect: a reduction also in the incidence of dementia among older seniors.
Dementia: The right to rehabilitation
Rehabilitation is important for people with dementia as it is for people with physical disabilities, according to a leading dementia expert.
One in 4 elderly Australian women have dementia
At least a quarter of Australian women over 70 will develop dementia according to University of Queensland researchers.
Rural dementia -- we need to talk
Research carried out by Plymouth University into the experience of dementia in farming and farming families, and its impact on their businesses and home lives, has identified four areas of concern which need to be addressed if dementia in the countryside is to be managed.
Women with dementia receive less medical attention
Women with dementia have fewer visits to the GP, receive less health monitoring and take more potentially harmful medication than men with dementia, new UCL research reveals.
Dementia on the downslide, especially among people with more education
In a hopeful sign for the health of the nation's brains, the percentage of American seniors with dementia is dropping, a new study finds.
New study suggests rethink of dementia causes
University of Adelaide researchers have developed a new theory for the causes of dementia and other neurodegenerative diseases, involving an out-of-control immune system.
Bleeding stroke associated with onset of dementia
Bleeding within the brain, or intracerebral hemorrhage, was associated with a high risk of developing dementia post stroke, according to research presented at the American Stroke Association's International Stroke Conference 2016.
Dementia: New insights into causes of loss of orientation
The University of Exeter Medical School led two studies, each of which moves us a step closer to understanding the onset of dementia, and potentially to paving the way for future therapies.

Related Dementia Reading:

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

Digital Manipulation
Technology has reshaped our lives in amazing ways. But at what cost? This hour, TED speakers reveal how what we see, read, believe — even how we vote — can be manipulated by the technology we use. Guests include journalist Carole Cadwalladr, consumer advocate Finn Myrstad, writer and marketing professor Scott Galloway, behavioral designer Nir Eyal, and computer graphics researcher Doug Roble.
Now Playing: Science for the People

#530 Why Aren't We Dead Yet?
We only notice our immune systems when they aren't working properly, or when they're under attack. How does our immune system understand what bits of us are us, and what bits are invading germs and viruses? How different are human immune systems from the immune systems of other creatures? And is the immune system so often the target of sketchy medical advice? Those questions and more, this week in our conversation with author Idan Ben-Barak about his book "Why Aren't We Dead Yet?: The Survivor’s Guide to the Immune System".