Vascular Dementia - Introduction

Vascular Dementia - Historic And Conceptual Context

As early as 1896 ??arteriosclerotic dementia?? (referring to VaD) was separated from ??senile dementia?? (referring to AD). Nevertheless, until the 1960s and 1970s cerebral atherosclerosis by chronically impairing blood supply to the brain was thought to be the commonest cause of dementia, and AD was regarded as a rare cause affecting only younger patients. Tomlinson et al. (Tomlinson, Blessed, an…

Vascular Dementia - Epidemiology

With the varying conceptions of vascular dementia, one understanding of epidemiology has been affected by variations in the definition of the disorders, the clinical criteria used, and the clinical methods applied. Prevalence. VaD is the second most common single cause of dementia, accounting for 10 to 50 percent of the cases, depending on the geographic location, patient population and clinical m…

Vascular Dementia - Etiology And Pathophsyiology

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 etiologi…

Vascular Dementia - Heterogeneity Of Vascular Dementias

Vascular Dementia - Main Subtypes Of Vascular Dementia

Cortical VaD (MID) is seen in connection with large vessel disease, cardiac embolic events and also hypoperfusion (see Table 2). It shows predominantly cortical and cortico-subcortical arterial territorial and distal field (watershed) infarcts. Typical clinical features are changes in strength or sensation on one side of the body, with facial problems such as language impairment, comprehension, an…

Vascular Dementia - Mixed Dementia

The so-called ??mixed dementia syndrome?? (which usually refers to the combination of Alzheimer?s disease and VaD) may have been underrepresented in our estimation of dementia subtypes. VaD and AD seem to be more closely linked than might be explained on the basis of coincidence. Several vascular risk factors related to VaD have been shown also to be risk factors of clinical AD. In addition, infar…

Vascular Dementia - Clinical Features Of Subcortical And Cortical Vad

The early cognitive syndrome of subcortical VaD is characterized by (1) dysexecutive syndrome including slowed information processing, (2) memory deficit (may be mild), and (3) behavioral and psychological symptoms. The dysexecutive syndrome in subcortical VaD includes impairment in goal formulation, initiation, planning, organising, sequencing, executing, setsifting and set-maintenance, as well a…

Vascular Dementia - Differential Diagnosis

The differential diagnosis of VaDs include a number of conditions (see Table 3), but chiefly AD. In consequence, the focus in a clinical diagnosis of AD has been on early episodic memory impairment, followed by often cognitive features, with a progressive course, with progressive dependence in function. This picture is distinct from early classical VaD. Table 3 Differential diagnosis of vascul…

Vascular Dementia - Prevention And Treatment Of Vascular Dementia

Primary prevention aims to reduce the incidence of a disease by eliminating its causes or main risk factors. In VaD dementia the targets are CVD, including arterial hypertension, atrial fibrillation, myocardial infarction, coronary heart disease, diabetes, generalized atherosclerosis, lipid abnormalities and smoking. In addition, the use of estrogen, anti-inflammatory agents and antioxidants appea…