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Published on: May 17, 2024
Vascular dementia
Timo Erkinjuntti1, Kenneth Rockwood
1Department of Neurology, University of Helsinki, Helsinki, Finland.
Insights
Vascular dementia (VaD), a subset of vascular cognitive impairment (VCI), involves cognitive decline due to cerebrovascular disease. Many VCI forms may be preventable by managing vascular risk factors early.
Area of Science:
- Neurology
- Gerontology
- Public Health
Background:
- Vascular dementia (VaD) is now understood as part of vascular cognitive impairment (VCI).
- VCI is characterized by cognitive impairment linked to cerebrovascular disease.
- VCI classification considers dementia criteria, overlap with neurodegenerative diseases, and neuroimaging findings.
Purpose of the Study:
- To clarify the definition and classification of vascular dementia (VaD) within the broader spectrum of vascular cognitive impairment (VCI).
- To highlight the prevalence and potential preventability of VCI.
Main Methods:
- Clinical classification based on dementia criteria and overlap with neurodegenerative diseases.
- Neuroimaging to identify subgroups: cortical infarction, subcortical infarction, and white matter changes.
- Review of existing literature on VaD treatment and VCI prevention.
Main Results:
- Vascular cognitive impairment (VCI) is likely the most common cause of cognitive impairment.
- Subgroups of VCI identified via neuroimaging include cortical infarction, subcortical infarction, and white matter changes.
- Previous treatment attempts for VaD showed limited success.
Conclusions:
- Vascular cognitive impairment (VCI) is a prevalent condition.
- Many forms of VCI may be preventable through proactive management of vascular risk factors.
- Early intervention targeting vascular health is crucial for preventing cognitive decline.
Abstract:
Vascular dementia (VaD) is a term used to describe a particular constellation of cognitive and functional impairment, and is now generally seen as a subset of the larger syndrome of vascular cognitive impairment (VCI). The latter is seen as cognitive impairment in the face of cerebrovascular disease. VCI can be classified clinically by whether patients meet criteria for dementia, and whether the syndrome is distinct or overlaps with primary neurodegenerative diseases, such as Alzheimer's disease. This clinical classification can be further classified by neuroimaging, with subgroups that show cortical infarction, subcortical infarction and white matter changes, each alone or in combination. Understood in this way, VCI is likely the most common form of cognitive impairment in the population. Attempts to treat VaD had varying degrees of success, but it now appears that many forms of VCI might be preventable, especially with good control of vascular risk factors in middle age.
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