Vascular Dementia

VaD as a clinical syndrome relates to different vascular mechanisms and changes in the brain, and has different causes and clinical manifestations. As noted, VaD is not only the traditional dementia of multiple strokes (Erkinjuntti Table 1 Etiologies of vascular dementia SOURCE: Author and Hachinski, 1993; Chui). The pathophsyiology of VaD incorporates interactions between vascular etiologies (CVD and vascular risk-factors), changes in the brain (in strokes, white matter lesions and atrophy), host factors (age, education) and cognition (see Figure 1).

Etiologies of VaD include both CVDs and risk factors (see Table 1). The main CVDs include large artery disease, cardiac embolic events, small vessel and hemodynamic mechanisms.

Risk factors for VaDs (see Table 1) include risk factors for CVD, stroke, white matter lesions, but, at the same time, also those of any cognitive decline and AD (Skoog).

Many changes in the brain are associated with VaD including several types of strokes, white matter lesions, and incomplete ischemic injury (occurring when brain cells are injured by chronic low blood flow to the brain.