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Gloria HY Wong, The University of Hong Kong,Bosco HM Ma, Hong Kong Alzheimer's Disease Association,Maggie NY Lee, Hong Kong Alzheimer's Disease Association,David LK Dai, Hong Kong Alzheimer's Disease Association
Readers are presented with 19 case examples of atypical Alzheimer’s disease, other dementias, and conditions resembling dementia. Each case comes with a summary of cognitive and functional assessment results, complaints by informants, clinical history, laboratory examinations indicated, diagnosis, and management, followed by insights from both medical and psychosocial perspectives. These are organised around the following themes: cases illustrative of when imaging and further observation are needed; cases that may be referred to as ‘pseudodementia’, and cases where a decision to refer on may be needed.
Vascular cognitive impairment (VCI) is currently considered the most recent modification of the terminology to reflect the all-encompassing effects of vascular disease or lesions on cognition and incorporates the complex interactions between vascular etiologies, risk factors and cellular changes within the brain and cognition. The recognition of Alzheimer's disease (AD) as the commonest cause of dementia led to the development of operational criteria for the diagnosis of dementia in general. Post-stroke cognitive impairment is frequent, although it has been a neglected consequence of stroke. The main subtypes of vascular dementia (VaD) included in current classifications are cortical VaD or MID, also referred to as post-stroke VaD, subcortical ischemic vascular disease and dementia (SIVD) or small vessel dementia, and strategic infarct dementia. AD with cerebrovascular disease (CVD) can present clinically either as AD with evidence of vascular lesions upon brain imaging, or with clinical features of both AD and VaD.
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