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Patient experience and advocacy

TL;DR — VCI can combine cognitive slowing, focal stroke disability, gait problems, mood change, recurrent-event fear, and an uncertain or changing diagnostic label. Published post-stroke qualitative work reports that memory problems are often under-recognized and that people and families encounter barriers to seeking help (Tang 2019, PMID 30452613; Tang 2020, PMID 32637417). Dementia-caregiver syntheses describe sustained coordination, relationship change, uncertainty, and cultural variation, but vascular-specific qualitative research is sparse (Macdonald 2020, PMID 32813338; Nguyen 2023, PMID 35549573). Advocacy priorities are timely explanation, accessible cognitive testing, joined stroke–memory services, practical rehabilitation, caregiver support, and research outcomes tied to daily life.

Qualitative samples are small and English-language-skewed. Tang 2019 is a family-practice qualitative study of post-stroke memory problems and help-seeking; Tang 2020 is a separate qualitative study of patient and carer impact; McMahon 2024 analysed acceptability of post-stroke cognitive testing through the theory of acceptance (Tang 2019, PMID 30452613; Tang 2020, PMID 32637417; McMahon 2024, PMID 38226361). Macdonald 2020 is a qualitative systematic review of spousal/partner community dementia caregiving, not a vascular-specific prevalence estimate (Macdonald 2020, PMID 32813338).

Distinctive experience domains

Domain VCI-specific expression
diagnostic uncertainty “vascular,” “mixed,” “post-stroke,” and “dementia” labels shift
variable course recovery, plateaus, steps, and gradual decline coexist
combined disability cognition plus weakness, aphasia, gait, fatigue
recurrence fear another stroke may change function abruptly
invisible impairment executive/memory problems missed after motor recovery
treatment burden BP/AF/diabetes regimens plus cognitive support
caregiver coordination appointments, medication, safety, communication

Evidence themes

Cognitive problems need recognition and a route to help

Post-stroke qualitative studies found memory difficulties affected patients and family carers and identified barriers to help-seeking, supporting systematic explanation and follow-up (Tang 2019, PMID 30452613; Tang 2020, PMID 32637417). A separate qualitative study examined acceptability of cognitive testing, emphasizing that testing is an experience, not a neutral measurement event (McMahon 2024, PMID 38226361).

Function matters more than a score

People may value managing medication, cooking safely, following conversation, walking outside, or returning to roles more than a small cognitive-scale change. Drug trials often detect 1–2 ADAS-Cog points without consistent ADL benefit, exposing a mismatch between statistical and lived importance (Battle 2021, PMID 33704781). SPS3 showed that 41% of lacunar-stroke participants with almost no physical disability still met MCI criteria, which matches patient reports that cognitive problems are invisible after motor recovery (Jacova 2012, PMID 23034910).

Caregiver work is both practical and emotional

Qualitative synthesis of spousal dementia caregiving identifies ongoing role change, vigilance, and adaptation; minority-ethnic caregivers additionally face culturally and structurally specific barriers (Macdonald 2020, PMID 32813338; Lillekroken 2023, PMID 34786789). These dementia-wide themes should not be assumed to have vascular-specific prevalence.

Culture shapes meaning and access

Systematic reviews in Vietnam/diaspora and low-/middle-income and Indigenous settings show that dementia understanding, stigma, family expectations, and pathways differ (Nguyen 2023, PMID 35549573; Johnston 2020, PMID 31074290). Advocacy cannot be reduced to translating one high-income service model.

Quantified unmet need after stroke

Qualitative themes are corroborated by one of the few surveys that counts them. Among 765 Australian community-dwelling stroke survivors at least 12 months post-stroke, 84% reported needs that were not fully met (median 4 of 20 domains; Q1–Q3 1–9). In multivariable models, fatigue, cognitive or emotional problems, younger age, and greater disability were each associated with more unmet needs (P<0.001). Domain-specific odds of unmet need were driven by disability (health domain aOR 3.4, 95% CI 1.9–6.0; work aOR 7.0, 95% CI 3.0–17.0; leisure aOR 3.8, 95% CI 2.2–6.5), by fatigue (health aOR 2.0, 95% CI 1.1–3.4), by being 1–2 years post-stroke (work aOR 3.4, 95% CI 1.5–7.8), and by memory problems specifically in the leisure domain (aOR 2.1, 95% CI 1.0–4.2) (Andrew 2014, PMID 25042019). Two features are worth naming: unmet need peaks in the second year — after most structured follow-up has ended — and cognition surfaces where participation is measured, not where health services are measured.

The invisibility problem is worse when acute treatment succeeds

Reperfusion therapy has changed who survives stroke with a good visible outcome, and the qualitative literature has begun to describe the consequence. Thirty-one semi-structured interviews with ischaemic stroke patients treated by endovascular clot retrieval (11), intravenous thrombolysis (10) or conservative management (10) — mean age 62.9 ± 17.5 — generated three themes, the third of which names the problem directly: invisible difficulties are easily missed when visible outcomes are positive. Participants across all three groups reported ongoing physical problems, fatigue, sleep and communication difficulties and cognitive impairment, with reduced participation, lost independence, adjustment difficulty and identity change; in those with good visible outcomes, particularly the clot-retrieval group, the invisible difficulties were under-recognized and untreated because post-discharge services did not exist for them (Humphrey 2026, PMID 40267272). This is the experiential counterpart to the SPS3 finding that 41% of lacunar-stroke patients with a modified Rankin of 0–1 and a Barthel of 100 meet MCI criteria, and it identifies needs that can remain hidden after a good visible outcome.

The service gap named by clinicians, not only by patients

A focus-group study of 40 primary- and secondary-care professionals across seven groups (thematic saturation reached) found that people with VCI and their caregivers "risk getting stuck in a no-man's land" between post-diagnostic care pathways. Three themes emerged: knowledge and awareness of VCI as a prerequisite for both pre-diagnostic detection and adequate post-diagnostic care; a perceived lack of differentiation between cognitive disorders in existing services; and fragmentation, with the recommended fix being explicit integration of dementia and stroke/rehabilitation pathways (van de Schraaf 2024, PMID 39240640). This is the professional-side mirror of the help-seeking barriers patients describe (Tang 2019, PMID 30452613), and it makes the fragmentation an addressable service-design problem rather than an inherent property of the diagnosis.

What information people ask for, and what the literature has studied instead

A scoping review of 30 studies published 1996–2023 across nine high-income countries found consistent demand for psychoeducation about cognitive impairment — specifically recovery expectations, treatment and therapy options, and signposting to services — and that hopeful framing mattered to recipients. Needs varied with time since stroke and with the family member's relationship. The review's central gap finding is that most of this research addressed aphasia, with very few studies covering memory, attention, or executive function (Hobden 2025, PMID 39819901). The domains most characteristic of vascular cognitive impairment are therefore the ones about which least is known regarding what patients want to be told.

Mood after stroke, counted

Mood disorder is the most quantified part of this experience and the numbers are large enough to reframe "cognitive follow-up" as something broader. A meta-analysis of structured-interview diagnoses across 147 assessments from 2 days to 7 years post-stroke found point prevalences of major depressive disorder 17.7% (95% CI 15.6–20.0) across 128 analyses in 15,573 patients, minor depression 13.1% (10.9–15.8), dysthymia 3.1% (2.1–5.3), adjustment disorder 6.9% (4.6–9.7), anxiety disorder 9.8% (5.9–14.8), and any depressive disorder 33.5% (30.3–36.8). Risk was higher after left-hemisphere stroke, in aphasia, and with personal or family history of mood disorder — but not related to time since stroke, meaning the risk does not resolve with the acute phase (Mitchell 2017, PMID 28807138).

Do behavioural symptoms differ in vascular dementia? Two datasets disagree

This is an unresolved contradiction worth stating plainly rather than averaging.

Study Setting and n Instrument Finding for VaD vs AD
Schwertner 2022 (PMID 35491774) 10,405 long-term-care residents, SveDem + Swedish BPSD registry NPI-NH Lower risk of agitation, anxiety and aberrant motor behaviour; higher risk of apathy
Anor 2017 (PMID 28245482) 180 memory-clinic patients with MRI (92 AD, 34 VaD, 54 mixed) NPI More agitation (40% vs 14%, P<0.05) and sleep disturbance (57% vs 32%, P<0.05); more depression (48% vs 20%) and aberrant motor behaviour (31% vs 13%) than mixed

The direction reverses for agitation and aberrant motor behaviour. Setting is the most likely explanation — institutional residents are further into the disease and are rated by staff on a nursing-home instrument, while memory-clinic patients are earlier and rated with informant input — but no study has tested that explanation directly, and until one does, "VaD is the agitated dementia" and "VaD is the apathetic dementia" both have registry-scale support. The one point of agreement is apathy, which both the long-term-care registry and the network-imaging literature identify as the vascular-leaning symptom (Schwertner 2022, PMID 35491774; see assessment). Anor's imaging sub-analysis adds a mechanistic hint that cuts across diagnosis: AD patients with delusions had greater right frontal WMH volumes than those without (314.8 vs 112.6 mm³), i.e. the vascular burden tracked the symptom regardless of the diagnostic label (Anor 2017, PMID 28245482).

Is caregiving in vascular dementia harder or easier? The comparison depends on stage

The two studies that compare caregiver burden between vascular and Alzheimer dementia directly reach opposite conclusions, and the reconciliation is disease stage.

In 506 consecutive patients from a geriatric Alzheimer evaluation unit (253 AD, 253 VaD) with caregivers assessed on the 24-item Caregiver Burden Inventory, AD caregivers reported higher burden on the objective (P=0.047), physical (P<0.0001), social (P=0.003), emotional (P<0.0001) and total (P<0.0001) subscales, and devoted more months of care (P=0.010) and more daily hours (P=0.011). The AD patients were also more cognitively impaired (MMSE P<0.0001) and at a more severe CDR stage (P<0.0001) at baseline, so the burden difference is confounded with disease severity (D'Onofrio 2015, PMID 25475248).

An older German homecare study that stratified explicitly by severity found the crossing point. Among 36 Alzheimer-type and 36 vascular-dementia homecare patients graded on the Global Deterioration Scale, caregiver burden, behavioural symptoms and inability with everyday tasks were sharply higher for Alzheimer disease in the severe stratum — but in the mild and moderate strata the Alzheimer scores were similar to or lower than the vascular ones, i.e. early vascular dementia imposes the greater burden and the relationship reverses with progression (Vetter 1999, PMID 10097779). The authors drew the service conclusion directly: the two conditions need separately designed home-care support.

Read together, the studies suggest that relative caregiver burden may vary by stage, but their different settings, instruments and case mix prevent a definitive reconciliation. Both are small-to-moderate, single-country, and predate current criteria; neither has been replicated.

Caregiver burden and cost

Caregiver burden in dementia is not static, and services change its trajectory. Across 720 patients from nine Australian memory clinics followed 3 years, 47.4% of caregivers had clinically significant burden at baseline, rising to 56.8% at 3 years; the increase occurred in caregivers of patients without services and was flat for those receiving services or residential care after adjustment. Greater neuropsychiatric symptoms, lower function, loss of driving ability and female caregiver sex predicted higher burden (Connors 2020, PMID 31821606). Driving cessation appearing as an independent predictor is directly relevant to the capacity and driving decisions covered in red flags.

Direct costs are one of the few places where vascular dementia has been measured separately rather than pooled into "dementia". In a 100,000-member Medicare HMO (1999–2002), annual healthcare costs were $14,387 for vascular dementia, $10,716 for other dementias, $8,254 for cerebrovascular disease without dementia, $7,839 for Alzheimer disease and $5,494 for controls (all P<0.0001 versus VaD). The pattern inside the total is informative: VaD patients had lower physician-visit and prescription costs than most comparison groups while having nearly twice the hospital admissions and roughly three times the hospital days of the cerebrovascular-disease-without-dementia group — a cost profile of under-used ambulatory care and over-used inpatient care (Hill 2005, PMID 16155348). The figures are two decades old and US-specific. One middle-income comparison exists and shows a different total with a similar internal shape: among 104 Argentine dementia patients (44 Alzheimer, 34 frontotemporal, 26 vascular) evaluated 2002–2008 and matched to 29 healthy controls, annual direct costs were US$4,625 (AD), US$4,924 (FTD) and US$5,112 (VaD) with no significant difference between groups — but on post-hoc analysis vascular dementia carried significantly higher hospitalization costs than Alzheimer disease (P<0.001) and lower medication costs than frontotemporal dementia (P<0.001); depression, activities of daily living, and caregiver burden together explained most of the variance in direct cost (r²=0.76) (Rojas 2011, PMID 21044400). The small post-hoc comparison cannot establish that the pattern is invariant across health systems.

Informal care is the larger cost and is essentially unmeasured for this condition. A review of 21 studies comparing informal care time and cost across age-related dementias reported 55.73 hours per week and $17,492 per year for Alzheimer disease against 15.8 hours and $3,284 for Parkinson disease, and stated explicitly that data are lacking for dementias other than AD and PD (Costa 2013, PMID 23509789). Given the direct-cost gradient above, assuming the Alzheimer figure transfers to vascular dementia is unsafe in either direction.

Work

Return to work is the outcome that most distinguishes vascular cognitive impairment from late-onset dementia, because the population includes working-age stroke survivors. A systematic review of 39 studies (33 observational, 5 qualitative, 1 RCT) found post-stroke cognitive impairment prevalence ranging from 17.5% at 28 days to 89% at 7 years and return-to-work rates from 7.5% to 100%, with no clear trend by time since stroke or stroke subtype. Cognition was the variable most often associated with return-to-work outcome, ahead of stroke severity, mood and functional status; concentration, memory and processing speed were the impairments most often implicated; and the review highlights the invisibility of the impairment to employers and clinicians as a recurring finding (Cunningham 2026, PMID 41666123). The ranges are so wide because assessment practice is not standardized — which is a measurement failure, not a description of the population.

Even brief acute-phase testing carries signal. In 39 previously working adults under 65 with first-ever mild ischaemic stroke (NIHSS ≤3, pre-stroke mRS ≤1) tested within a week, each one-point increase in Clock Drawing Test score raised the odds of 3-month return to work by 3.79 (95% CI 1.10–14.14) and return to driving by 6.74 (1.22–37.23); MoCA predicted return to work at 6 months and clock drawing at 12 (Slavin 2022, PMID 34706294). The sample is small and the intervals correspondingly wide, but the direction supports offering cognitive assessment after mild stroke rather than reserving it for visible impairment.

When the patient already has dementia and has a stroke

About one in three stroke patients is living with pre-existing disability or dementia, and the evidence base for their acute management is thin. In a mixed-methods study of 30 interviewed and 132 surveyed physicians, severity of the prior condition (87–89%) and quality of life (87–88%) were rated very or extremely important in setting goals of care — but the interviews described profound uncertainty in evaluating those factors, attributed to missing information about patients' prior well-being and wishes and to a paucity of condition-specific evidence. The physicians named the consequence themselves: individualized decisions made under that much ambiguity carry a high risk of bias affecting equity (Drozdowska 2026, PMID 42339544). The proposed remedies — routine documentation of baseline well-being and advance directives, and inclusion of these patients in stroke trials — are advocacy targets as much as clinical ones.

Measuring outcomes from the patient's side

Until recently no instrument measured small-vessel-disease outcomes from the patient's perspective. CADA-PRO was generated from 79 items by consensus among patients, family representatives, and SVD experts, developed in 44 patients and validated in 89 more (43 CADASIL, 46 other SVD). The final 18-item scale covers depression/anxiety, attention/executive function, motor function, and daily activities, with low missing data, no major floor or ceiling effect, Cronbach α = 0.95 and test–retest ICC = 0.88. In CADASIL it correlated with the modified Rankin Scale, Starkstein Apathy Scale, HADS, Working Memory Index, and trail-making times — but in other small-vessel diseases it correlated only with HADS and the apathy scale, and full validation was claimed only for CADASIL (Di Folco 2024, PMID 39234671). A patient-reported measure that tracks cognition and disability in a monogenic disease and mood alone in sporadic disease is either detecting a genuine phenotypic difference or failing to transport; either way, sporadic VCI still has no fully validated patient-reported outcome measure.

Care pathway needs

Stage Information/support need
acute stroke explain delirium vs cognitive injury and uncertainty
rehabilitation accessible assessment and strategy training
diagnosis explain mixed pathology without false certainty
home transition medication, appointments, safety, respite
progression capacity, driving, finance, future care planning
recurrent event rapid reassessment and caregiver support

Patient-centered outcomes

Outcome Why it matters
independent medication management cognition–vascular-risk feedback
participation captures valued roles
communication access prevents aphasia exclusion
falls and mobility combined gait/cognitive burden
caregiver time/distress treatment externalities
goal attainment heterogeneity of deficits
diagnostic understanding enables planning

Advocacy landscape

VCI often lacks a distinct advocacy identity and is served by dementia, stroke, CAA, CADASIL, and rare-disease organizations. This fragmentation mirrors biology but can leave people uncertain which service owns cognitive follow-up. The verified organization directory is in literature/patient-voice/organizations.md.

Ethical synthesis rules

  • Public sources only.
  • Aggregate themes; no private names or dossiers.
  • Paraphrase; no quotation was reproduced in this build.
  • Qualitative themes establish experience patterns, not prevalence.
  • Caregiver reports do not replace patient reports.
  • Testimonials do not establish treatment efficacy.
  • Report exclusion of aphasia or severe impairment when known.

Research participation

VCI trials commonly exclude people with aphasia, severe stroke, sensory impairment, limited literacy, or absent study partners—the people with greatest burden. Supported consent, accessible materials, remote/hybrid follow-up, and proxy-plus-patient outcome design can broaden participation while preserving autonomy.

Open questions

  • Does caregiver burden in vascular dementia exceed Alzheimer burden at mild-to-moderate stages and fall below it at severe stages, as the one stage-stratified study suggests? (Vetter 1999, PMID 10097779; D'Onofrio 2015, PMID 25475248)
  • Do successful reperfusion therapies create a growing population with good visible outcomes and unserved invisible cognitive impairment? (Humphrey 2026, PMID 40267272)
  • Is the hospital-heavy, medication-light cost profile of vascular dementia a care-pathway property rather than a health-system artifact, given that it replicates from the US to Argentina? (Hill 2005, PMID 16155348; Rojas 2011, PMID 21044400)
  • Which outcomes do people with VCI prioritize over cognitive-scale change? (Tang 2020, PMID 32637417)
  • How can post-stroke testing become acceptable and actionable? (McMahon 2024, PMID 38226361)
  • What services best join stroke prevention and dementia support? (Swartz 2025, PMID 39822128)
  • Why does unmet need peak in the second year after stroke, when structured follow-up has usually ended? (Andrew 2014, PMID 25042019)
  • Why does CADA-PRO track cognition and disability in CADASIL but only mood in sporadic small-vessel disease? (Di Folco 2024, PMID 39234671)
  • What do patients want to be told about memory, attention, and executive function, given that psychoeducation research has focused on aphasia? (Hobden 2025, PMID 39819901)
  • Would integrating dementia and stroke/rehabilitation pathways close the VCI "no-man's land" that clinicians describe? (van de Schraaf 2024, PMID 39240640)
  • Does setting explain the reversed direction of agitation and aberrant motor behaviour between long-term-care and memory-clinic BPSD datasets? (Schwertner 2022, PMID 35491774; Anor 2017, PMID 28245482)
  • What is informal care time and cost in vascular dementia, given that the comparative literature covers only AD and PD? (Costa 2013, PMID 23509789)
  • Does the 2005 cost profile — low ambulatory, high inpatient — still hold, and would better ambulatory care shift it? (Hill 2005, PMID 16155348)
  • Why do return-to-work rates after stroke span 7.5–100%, and how much of that range is assessment heterogeneity rather than population difference? (Cunningham 2026, PMID 41666123)
  • Does providing services prevent the rise in caregiver burden, or do service recipients differ from non-recipients in ways adjustment cannot remove? (Connors 2020, PMID 31821606)
  • How should stroke services decide goals of care for the one in three patients already living with dementia or disability, without the decision becoming inequitable? (Drozdowska 2026, PMID 42339544)
  • How do patient priorities differ in inherited SVD, CAA, and post-stroke syndromes?

References

  1. Tang EYH, et al. Post-stroke memory deficits and barriers to seeking help. Fam Pract. 2019. PMID 30452613
  2. Tang EYH, et al. Impact of memory problems post-stroke on patients and family carers. Front Med (Lausanne). 2020. PMID 32637417
  3. McMahon D, et al. Acceptability of post-stroke cognitive testing. Cereb Circ Cogn Behav. 2024. PMID 38226361
  4. Macdonald M, et al. Experiences and perceptions of spousal/partner caregivers providing care for community-dwelling people with dementia: a systematic review. JBI Evid Synth. 2020. PMID 32813338
  5. Lillekroken D, et al. Family caregivers' experiences of providing care for family members from minority ethnic groups living with dementia: a qualitative systematic review. J Clin Nurs. 2023. PMID 34786789
  6. Nguyen TA, et al. Experiences and perceptions of dementia in Vietnam and diaspora. Aging Ment Health. 2023. PMID 35549573
  7. Johnston K, et al. Understandings of dementia in low and middle income countries and amongst indigenous peoples: a systematic review and qualitative meta-synthesis. Aging Ment Health. 2020. PMID 31074290
  8. Battle CE, et al. Cholinesterase inhibitors for VCI. Cochrane Database Syst Rev. 2021. PMID 33704781
  9. Swartz RH, et al. Canadian Stroke Best Practice Recommendations: Vascular cognitive impairment. Alzheimers Dement. 2025. PMID 39822128
  10. Jacova C, et al. Cognitive impairment in lacunar strokes: the SPS3 trial. Ann Neurol. 2012;72:351-62. PMID 23034910
  11. Andrew NE, et al. Understanding long-term unmet needs in Australian survivors of stroke. Int J Stroke. 2014;9 Suppl A100:106-12. PMID 25042019
  12. van de Schraaf SAJ, et al. Healthcare professionals' perspectives on post-diagnostic care for people with vascular cognitive impairment: when help is needed in a "no-man's land". J Alzheimers Dis. 2024;101:1001-1013. PMID 39240640
  13. Hobden G, et al. Research investigating patient and carer psychoeducation needs regarding post-stroke cognition: a scoping review. BMJ Open. 2025;15:e084681. PMID 39819901
  14. Di Folco C, et al. CADA-PRO: a patient questionnaire measuring key cognitive, motor, emotional, and behavioral outcomes in CADASIL. Stroke. 2024;55:2439-2448. PMID 39234671
  15. Mitchell AJ, et al. Prevalence and predictors of post-stroke mood disorders: a meta-analysis and meta-regression of depression, anxiety and adjustment disorder. Gen Hosp Psychiatry. 2017;47:48-60. PMID 28807138
  16. Schwertner E, et al. Behavioral and psychological symptoms of dementia in different dementia disorders: a large-scale study of 10,000 individuals. J Alzheimers Dis. 2022;87:1307-1318. PMID 35491774
  17. Anor CJ, et al. Neuropsychiatric symptoms in Alzheimer disease, vascular dementia, and mixed dementia. Neurodegener Dis. 2017;17:127-134. PMID 28245482
  18. Connors MH, et al. Dementia and caregiver burden: a three-year longitudinal study. Int J Geriatr Psychiatry. 2020;35:250-258. PMID 31821606
  19. Hill J, et al. Patterns of healthcare utilization and costs for vascular dementia in a community-dwelling population. J Alzheimers Dis. 2005;8:43-50. PMID 16155348
  20. Costa N, et al. Comparison of informal care time and costs in different age-related dementias: a review. Biomed Res Int. 2013;2013:852368. PMID 23509789
  21. Cunningham LJ, et al. Post-stroke cognitive impairment is associated with poorer return-to-work outcomes in working-aged stroke survivors: a systematic review. Clin Rehabil. 2026;40:1216-1253. PMID 41666123
  22. Slavin SJ, et al. Cognitive testing during mild acute ischemic stroke predicts long-term return to work. J Stroke Cerebrovasc Dis. 2022;31:106132. PMID 34706294
  23. Drozdowska BA, et al. Physician approaches to determining goals of stroke care for patients living with disability or dementia: results from the SEED mixed-methods study. Stroke. 2026;57:2325-2339. PMID 42339544
  24. D'Onofrio G, et al. Caregiver burden characterization in patients with Alzheimer's disease or vascular dementia. Int J Geriatr Psychiatry. 2015;30:891-9. PMID 25475248
  25. Vetter PH, et al. Vascular dementia versus dementia of Alzheimer's type: do they have differential effects on caregivers' burden? J Gerontol B Psychol Sci Soc Sci. 1999;54:S93-8. PMID 10097779
  26. Humphrey S, et al. Invisible difficulties are easily missed when visible outcomes are positive: a qualitative study of patient perspectives following acute treatments for ischaemic stroke. Neuropsychol Rehabil. 2026;36:131-149. PMID 40267272
  27. Rojas G, et al. Clinical and economic characteristics associated with direct costs of Alzheimer's, frontotemporal and vascular dementia in Argentina. Int Psychogeriatr. 2011;23:554-61. PMID 21044400