Neuropsychological function in patients with peripheral vascular disease.
Date
1996
Authors
Phillips, Natalie Anne.
Journal Title
Journal ISSN
Volume Title
Publisher
Dalhousie University
Abstract
Description
Atherosclerosis causes ischemia in cerebral and peripheral arteries. Patients with atherosclerosis in lower-extremity arteries (PVD) are at high risk for cerebrovascular disease (CVD). PVD and CVD can co-exist within an individual, although only the former might be recognized clinically. Three studies tested the hypothesis that PVD patients without diagnosed stroke have neuropsychological deficits, presumably due to concomitant CVD. Study 1 compared 14 PVD patients with 14 matched controls on a comprehensive neuropsychological battery. PVDs performed worse $(p<.002)$ on tests of attention and psychomotor speed (WAIS-R Digit Symbol) and executive function (Modified Card Sorting). Study 2 tested whether PVDs show a similar pattern of neuropsychological impairment as symptomatic CVD patients. It also tested the hypothesis that, of the medical factors PVD severity, transient ischemic attack, heart disease, hypertension, diabetes, hyperlipidemia, and smoking, the best predictor of impairment would be PVD severity. Memory, attention, language, visuoconstructional ability, executive function, and sensory/motor function were examined in 29 PVDs, 29 CVDs, and 30 matched controls. PVDs were impaired $(p<.002,$ in executive function (Wisconsin Card Sorting perseverative errors*, conceptual responses*; WAIS-R Picture Arrangement), attention (Trail Making B*; WAIS-R Digit Symbol), visuospatial ability (WAIS-R Block Design*; Rey Figure*), and non-verbal memory (Rey Figure recall*). On indicated tests (*), PVDs performed as poorly as CVDs. PVD severity and ischemic heart disease were medical predictors of impairment (mean variance explained: 14% and 19%, respectively). Depression did not relate to cognitive performance. Study 3 examined whether neuropsychological performance predicted functional outcome in 19 PVDs at one year. Deficits in attention, memory, and visuospatial function related to greater dependence in everyday activities.
Summary. PVD patients have deficits in attention, executive function, and visuospatial ability. The nature and magnitude was similar to that in patients with known cerebrovascular infarcts. Markers of generalized atherosclerosis predicted neuropsychological impairment. Even in the absence of demonstrable infarcts, atherosclerosis may be a factor in vascular-related cognitive decline.
Thesis (Ph.D.)--Dalhousie University (Canada), 1996.
Summary. PVD patients have deficits in attention, executive function, and visuospatial ability. The nature and magnitude was similar to that in patients with known cerebrovascular infarcts. Markers of generalized atherosclerosis predicted neuropsychological impairment. Even in the absence of demonstrable infarcts, atherosclerosis may be a factor in vascular-related cognitive decline.
Thesis (Ph.D.)--Dalhousie University (Canada), 1996.
Keywords
Psychology, Psychobiology., Psychology, Clinical., Psychology, Physiological.