International Psychogeriatrics
Volume 15, Supplement 1 - 2003

IPA EXPERT CONSENSUS CONFERENCE
“Vascular Burden of the Brain: New Therapeutic Directions”
Guest Editors: John O’Brien, Barry Reisberg, and Timo Erkinjuntti

GUEST EDITORIAL
Vascular Burden of the Brain, p7
John O’Brien (United Kingdom), Barry Reisberg (United States), and Timo Erkinjuntti (Finland)

BACKGROUND AND CURRENT CONCEPTS OF ETIOPATHOGENESIS

Vascular Dementia: A Historical Background, p11
Gustavo Román (United States)

Monogenic Causes of Stroke, p15
Martin Dichgans (Germany)

Subcortical Ischemic Vascular Disease and Dementia, p23
Timo Erkinjuntti (Finland)

Classification and Subtypes of Vascular Dementia, p27
Anders Wallin, Veronica Milos, Magnus Sjögren (Sweden), Leonardo Pantoni (Italy), and Timo Erkinjuntti (Finland)

Mixed Dementia: Alzheimer’s and Cerebrovascular Disease, p39
Kenneth Rockwood (Canada)

Vascular Factors in Alzheimer’s Disease, p47
Raj N. Kalaria (United Kingdom)

PATHOPHYSIOLOGY

Vascular Burden of the White Matter, p53
Arne Brun (Sweden)

Pathophysiology of Cerebral Small Vessels in Vascular Cognitive Impairment, p59
Leonardo Pantoni and Michela Simoni (Italy)

Small Vessel Disease: Neuropathology, p67
David G. Munoz (Spain)

Neuropathology of Vascular Cognitive Impairment and Vascular Dementia, p71
Paul G. Ince and Malee S. Fernando (United Kingdom)

Cell Cycle-Related Protein Expression in Alzheimer’s Disease and Vascular Disease, p77
Zsuzsanna Nagy (United Kingdom)

Neurotransmitter Abnormalities in Vascular Dementia, p81
Jenny A. Court and Elaine K. Perry (United Kingdom)

Potential Biological Markers for Cerebrovascular Disease, p89
Alexander Kurz (Germany), Matthias Riemenschneider (Germany), and Anders Wallin (Sweden)

EPIDEMIOLOGY

Epidemiology of White-Matter Lesions, p99
Lenore J. Launer (United States)

Epidemiology of Cerebrovascular Disease Related Cognitive Decline, p105
Chengxuan Qiu and Laura Fratiglioni (Sweden)

Vascular Dementia: A Diagnostic Challenge, p111
Gabriel Gold (Switzerland)

Epidemiology: Identifying Vascular Cognitive Impairment, p115
John Bowler (United Kingdom)

CLINICAL PHENOMENOLOGY

Mild Cognitive Impairment and Vascular Cognitive Impairment in Stroke Patients, p123
Clive Ballard, Sally Stephens, Andrew McLaren, Keith Wesnes, and RoseAnne Kenny (United Kingdom)

Cognitive Syndrome(s) in Preclinical and Clinical Vascular Dementia, p127
Ove Almkvist (Sweden)

Behavioral Symptoms in Vascular Cognitive Impairment and Vascular Dementia, p133
John O’Brien (United Kingdom)

PRIMARY PREVENTION (BRAIN AT RISK OF CVD)

Hypertension and Cognition, p139
Ingmar Skoog (Sweden)

Prevention of White-Matter Lesions Through Control of Cerebrovascular Risk Factors, p147
Charles DeCarli (United States)

Is Cholesterol a Culprit in Alzheimer’s Disease?, p153
D. Larry Sparks, Marwan N. Sabbagh, John C. S. Breitner, and John C. Hunsaker III (United States)

SECONDARY PREVENTION (CVD BRAIN AT RISK OF COGNITIVE DECLINE)

Acute Stroke, p161
Hugh Markus (United Kingdom)

Prevention of Stroke Recurrence, p167
Philip B. Gorelick (United States)

Slow Progression of White-Matter Changes, p173
Reinhold Schmidt, Helena Schmidt, Peter Kapeller, and Franz Fazekas (Austria)

TARGETED THERAPIES

History of Symptomatic Therapy in Vascular Dementia, p177
Mario Fioravanti (Italy)

Vascular Burden and BPSD: A Reconceptualization, p183
Edmond Chiu (Australia)

Galantamine in the Treatment of Vascular Dementia, p187
H. Robert Brashear (United States)

Patient Populations in Clinical Studies of Donepezil in Vascular Dementia, p195
Raymond D. Pratt (United States)

Rivastigmine in Vascular Dementia, p201
Shoona Vincent (United Kingdom) and Roger Lane (United States)

Memantine in Vascular Dementia, p207
Hans Jörg Möbius and Albrecht Stöffler (Germany)

TRIAL DESIGNS: SYMPTOMATIC

General Measures of Cognition, p215
Steven H. Ferris (United States)

Assessment of Executive Function in Clinical Trials, p219
Raija Ylikoski and Tuomo Hänninen (Finland)

Activities of Daily Living and Global Functioning, p225
Domenico Inzitari and Anna Maria Basile (Italy)

Staging: Relevance for Trial Design in Vascular Burden of the Brain, p231
Barry Reisberg, Steven H. Ferris, Thet Oo, and Emile Franssen (United States)

Behavioral and Psychological Symptoms of Dementia: Trial Design, p241
Alistair Burns (United Kingdom)

Psychosocial Intervention for Dementia Caregivers: What Can It Accomplish?, p247
Mary S. Mittelman (United States)

Societal Burden and Economics of Vascular Dementia: Preliminary Results From a Swedish-Population–Based Study, p251
Anders Wimo and Bengt Winblad (Sweden)

TRIAL DESIGNS: SLOW PROGRESSION

Does Vascular MCI Progress at a Different Rate Than Does Amnestic MCI?, p257
Serge Gauthier and Kenneth Rockwood (Canada)

White-Matter Changes on MRI as Surrogate Marker, p261
Philip Scheltens (The Netherlands), Frederik Barkhof (The Netherlands), and Franz Fazekas (Austria)

Functional Brain Imaging as a Surrogate Marker in Vascular Cognitive Impairment, p267
Etsuro Mori (Japan)

TRIAL DESIGNS: ISSUES

Guidelines for Brain Imaging in Vascular Dementia Clinical Trials, p273
Frederik Barkhof (The Netherlands)

REGULATORY ISSUES: ACADEMIC VIEWPOINTS

Regulatory Perspectives: One Academic Viewpoint From the United States, p277
Peter Whitehouse (United States)

Regulatory Issues, p283
José L. Molinuevo and Rafael Blesa (Spain)

Regulatory Issues: An Academic Viewpoint From Asia (Ex-Japan), p287
Christopher P. L.-H. Chen (Singapore)

REGULATORY ISSUES: REGULATORY AGENCIES

Regulatory Aspects of Vascular Dementia in the United States, p293
Armando Oliva, Ranjit Mani, and Russell Katz (United States)

Regulatory Issues in Vascular Dementia: A European Perspective, p297
Karl Broich (Germany)