DAFTAR ISI

Halaman

Daftar Isi............................................................................................................ .. i

Daftar Singkatan ............................................................................................... .. iii

Daftar Tabel....................................................................................................... .. v

Daftar Gambar................................................................................................... .. v

Abstrak ........................................................................................................ .. vi

BAB I. PENDAHULUAN ............................................................................. .. 1

BAB II. TINJAUAN PUSTAKA ................................................................... .. 3

2.1. Sejarah.......................................................................................... .. 3

2.2. Definisi......................................................................................... .. 4

2.3. Epidemiologi................................................................................ .. 5

2.4. Etiologi dan Faktor Risiko............................................................ .. 6

2.5. Patofisiologi ................................................................................. .. 8

2.6. Klasifikasi Demensia Vaskular ................................................... .. 11

2.7. Gambaran Klinis Umum .............................................................. .. 14

2.8. Diagnosis...................................................................................... .. 24

2.9. Perubahan Psikiatri dan Neurologi .............................................. .. 26

2.9.1. Kepribadian......................................................................... .. 26

2.9.2. Halusinasi dan Delusi.......................................................... .. 27

2.9.3. Mood.................................................................................... .. 28

i
 2.9.4. Perubahan Kognitif.............................................................. .. 29

2.9.5. Reaksi Katastropik............................................................... .. 29

2.9.6. Sundowner Syndrome.......................................................... .. 30

2.10. Diagnosis Banding ................................................................... . .. 31

2.10.1. Demensia Vaskular Lawan Demensia Tipe Alzheimer ... .. 31

2.10.2. Demensia Vaskular Lawan Serangan Iskemik Transien . .. 31

2.10.3. Delirium ........................................................................... .. 32

2.10.4. Depresi ............................................................................. .. 32

2.10.5. Gangguan Buatan ............................................................ .. 32

2.10.6. Skizofrenia ....................................................................... .. 32

2.10.7. Penuaan Normal .............................................................. .. 33

2.10.8. Gangguan Lainnya ........................................................... .. 33

2.11. Tatalaksana................................................................................. .. 33

2.11.1. Farmakoterapi .................................................................. .. 34

2.11.2. Nonfarmakoterapi ............................................................ .. 36

2.12. Perjalanan Penyakit dan Prognosis............................................. .. 37

2.13. Faktor Psikologi ......................................................................... .. 38

BAB III KESIMPULAN ................................................................................ .. 39

DAFTAR PUSTAKA....................................................................................... .. 40

ii
 DAFTAR SINGKATAN

DSM-5 : Diagnostic and Statistical Manual Mental Disorder Fifth Edition

BPSD : Behavioral and Psychological Symptoms in Dementia

VCI : Vascular Cognitive Impairment

NCD : Neurocognitive Disorder

NINDS-AIREN : National Institute of Neurological Disorders and Stroke-

Association Internationale pour le Recherche et l’Enseignment
en Neurosciences

PPDGJ-III : Pedoman Diagnostik Gangguan Jiwa-III

CADASIL : Cerebral Autosomal Dominant Arteriopathy with Subcortical

Infarcts and Leucoencephalopathy

VaD : Demensia Vaskular

HDL : High Density Lipoprotein

ROS : Reactive Oxygen Species

BBB : Blood Brain Barrier

MMP : Matrix Metalloprotease

IL-1, IL-6 : Interleukin-1, Interleukin-6

TNF-α : Tumor Necrosis Factor-α

TLR-4 : Toll Like Receptor-4

ApoE : Apolipopretein E

VICCCS : Vascular Impairment of Cognition Classification Consesnsus

Study

PSD : Post Stroke Dimentia

iii
SIVD : Subcortical Ischemic Vascular Dementia

MID : Multi-infarct Dementia

IADL : Instrumental Activity Daily Living

BADL : Basic Activity Daily Living

FFM : Five Factor Model

iv
 DAFTAR TABEL

Tabel 2.1. Domain Kognisi, Contoh Gejala, dan Pemeriksaan DSM-5 ........... .. 16

DAFTAR GAMBAR

Gambar 2.1. Patogenesis Demensia Vaskular................................................... .. 11

Gambar 2.2. Klasifikasi diagnostic VICCCS.................................................... .. 34

v
 ABSTRAK

Demensia vaskular atau yang sekarang dikenal sebagai Vascular

Neurocognitive Disorder merupakan demensia kedua yang paling umum dijumpai
setelah demensia Alzheimer. Vascular NCD  mengacu pada semua bentuk gangguan
kognitif yang terkait dengan penyakit serebrovaskular. Faktor risiko serebrovaskular,
seperti hipertensi, stroke, fibrilasi atrium, diabetes mellitus merupakan faktor risiko
utama dari demensia tipe ini. Faktor lain yang mempengaruhi, termasuk usia tua,
status pendidikan yang rendah, atrofi korteks, riwayat menderita penyakit vaskular
sebelumnya, serta aterosklerosis. Gejala yang ditunjukkan sama dengan gejala
demensia pada umumnya meliputi komponen neuropsikologis, neuropsikiatri
(Behavioral and Psychological Symptom in Dementia), gangguan pada komponen
Activity Daily Living, disertai gejala penyakit serebrovaskular yang mendasari
terjadinya gangguan neurokognitif. Disebutkan bahwa pendekatan utama terapi
Vascular NCD adalah berupa manajemen faktor risiko dan simptomatik dengan obat-
obat demensia. Namun, penelitian mengenai manajemen faktor risiko ini juga masih
sedikit diteliti.

vi