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Vascular dementia today.

G C Román1

  • 1Dept Medicine/Neurology, UT Health Science Center, San Antonio 78284-7883, USA. romang@uthscsa.edu

Revue Neurologique
|January 19, 2000
PubMed
Summary
This summary is machine-generated.

Vascular dementia (VaD) is a significant cause of senile dementia, with various pathological mechanisms contributing to its development. Controlling vascular risk factors like hypertension offers hope for preventing VaD.

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Area of Science:

  • Neurology
  • Geriatrics
  • Pathology

Background:

  • Vascular dementia (VaD) is a growing cause of senile dementia, with evolving diagnostic criteria.
  • Pathogenetic mechanisms beyond multi-infarct dementia are crucial in VaD.
  • Ischemic lesions, including lacunes and white matter changes, impact frontal executive functions and can co-occur with Alzheimer's disease.

Purpose of the Study:

  • To review the current understanding of vascular dementia (VaD) and its pathogenesis.
  • To discuss the clinical presentations and underlying mechanisms of VaD.
  • To highlight potential prevention strategies for VaD.

Main Methods:

  • Literature review of recent diagnostic criteria and research on VaD.
  • Analysis of pathogenetic mechanisms including strokes, hypoxic-ischemic events, and white matter lesions.

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  • Discussion of clinical subtypes and genetic factors (e.g., CADASIL).
  • Main Results:

    • VaD involves diverse mechanisms like subcortical strokes and Binswanger-type lesions, affecting executive functions.
    • Acute VaD includes large-vessel infarction and lacunar dementia; subacute VaD includes Binswanger's disease and CADASIL.
    • The genetic basis of CADASIL provides insights into Binswanger's disease pathogenesis.

    Conclusions:

    • VaD encompasses various ischemic vascular lesions contributing to cognitive decline.
    • Understanding these mechanisms, including genetic factors, is key to advancing VaD research.
    • Epidemiological data suggest that managing vascular risk factors, such as hypertension, may prevent VaD and other dementias.