Date of Award

8-1-2018

Document Type

Open Access Thesis

Degree Name

Master of Medical Science (MMSc)

First Advisor

Dr. Arash Salardini, MD

Abstract

Vascular Dementia (VaD) is an important public health concern, which causes significant morbidity and mortality amongst populations around the world. With the increases in average age of individuals and prevalence of cardiovascular risk factors, the incidence of vascular cognitive impairment (VCI) and VaD are on the rise. Most of this increase will come from cerebral small vessel disease (CSVD) as treatment for large vessel disease improves. Yet, very few interventions are recommended for CSVD beyond control of risk factors. In this thesis, we propose a non-pharmacological intervention, which we believe may address executive dysfunction in VCI due to CSVD. CSVD impairs functional frontal-subcortical connectivity and results in cognitive and functional impairments. Given the plasticity in these circuits, despite old age, cognitive training may be a good candidate for improving cognition in CSVD. However, previous studies have suffered from heterogeneity of pathologies in VCI by including both large and small vessel disease. Furthermore, they have often not considered the effects of anxiety and depression, which we aim to exclude from the study. Finally, these studies do not use validated composite scores as a primary endpoint and currently do not use any biomarkers to follow the progress of subjects. In this study, we aim to partially address these shortcomings and offer a more rigorous approach to cognitive training.

Open Access

This Article is Open Access

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