Risk Factors and Therapies for Vascular Dementia:

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Presentation transcript:

Risk Factors and Therapies for Vascular Dementia: An Integrative Review of the Literature Lauren Davis DePaul University School of Nursing Purpose Conceptual Framework Methodology Conclusion Research Objectives The purpose of this integrative literature review is to identify the risk factors and health behaviors that contribute to vascular dementia A secondary objective is to review the proposed treatments for vascular dementia as described in the literature Relevance A rise in the aging population will increase the cost, burden and need for better understanding of those with dementia There is research on Alzheimer dementia which has well-established diagnostic criteria, but this does not yet exist for vascular dementia VaD is the most expensive form of dementia to care for costing approximately $18,621.04 annually There is no cure for VaD Brain Images: Healthy vs. VaD Pender’s Model of Health Promotion Cognitive-perceptual factors such as: Perceived benefits of health promotion Barriers to health promotion Self-efficacy of health promotion Considers how these factors influence individuals’ engagement in the promotion of their own health Modifying factors also influence cognitive-perceptual processes like: Demographic characteristics Interpersonal influences Behavioral factors Helps to identify healthy and unhealthy behaviors Modifiable risk factors that may contribute to VaD: Smoking Alcohol consumption Obesity Lack of physical activity Hypertension Hyperglycemia Hyperlipidemia Integrative Literature Review Two searches in the Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete and PsychINFO Boolean phrase included: “vascular dementia” “cognitive impairment” “risks” Inclusion data: Articles from published from 2015 until present Peer-reviewed Full-text English language Adult human subjects (if applicable) 14 articles included in review There are several themes that are evident after reviewing the literature with regards to both risk factors and therapies used in vascular dementia and are outlined in the data matrix Authors of these works also call for more studies to further evaluate both risk factors and therapies Other potential areas of study include utilization of screening tools, protective effects against dementia, timing of lifestyle changes and its effects on dementia, and population-based studies Nursing Implications Assess all potential risk factors and their potential role in the development of VaD in all patients Increase patient awareness of VaD Provide additional resources and education on appropriate lifestyle and health behavior modifications Obtain a detailed drug history Utilize screening tools Montreal Cognitive Assessment (MoCA) Results Themes in the Literature: Risk Factors for Vascular Dementia Disease of the heart and vasculature Peripheral vascular disease Chronic heart disease Atrial fibrillation Hypertension Hypoperfusion Stroke Health behaviors Obesity (in those less than 65 years old) Smoking Alcohol consumption Socioeconomic status Low education Themes in the Literature: Therapies for Vascular Dementia Exercise Pharmacologic intervention Alternative therapies Acupuncture Herbal supplements Combination therapy Utilization of imaging technology Background Vascular dementia (VaD) is changes to the brain as result of diseases that affect the vasculature VaD causes vascular cognitive impairment (VCI), a spectrum of cognitive disorders ranging from mild cognitive impairment through fully developed dementia VaD may also cause aphasia, apraxia, agnosia, confusion, agitation, anterograde amnesia, gait disturbance, unprovoked falls, personality and mood changes, depression, mild memory deficit, psychomotor retardation, and abnormal executive function