Vascular dementia

Timo Erkinjuntti1, Kenneth Rockwood

  • 1Department of Neurology, University of Helsinki, Helsinki, Finland.

Seminars in Clinical Neuropsychiatry
|February 5, 2003
PubMed

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.

Related Concept Videos

Dementia l: Introduction01:22

Dementia l: Introduction

Dementia is an acquired, progressive syndrome characterized by a decline in multiple cognitive domains severe enough to impair daily functioning and reduce independence. Although memory loss is a central feature, the diagnosis requires additional deficits involving language, executive function, visuospatial skills, judgment, calculation, or abstract reasoning. These cognitive impairments reflect underlying neurodegenerative or vascular processes that gradually disrupt neuronal networks...
Dementia01:30

Dementia

Dementia is a collective term for cognitive disorders primarily affecting memory, thinking, and reasoning. It is not a specific disease but a syndrome, with Alzheimer's disease being the most common cause, accounting for approximately 60-80% of cases. Other types include vascular dementia, Lewy body dementia, and frontotemporal dementia. Dementia affects millions worldwide, particularly older adults, though it is not a normal part of aging.
The progression of dementia is generally gradual.
Alzheimer Disease l: Introduction01:29

Alzheimer Disease l: Introduction

Alzheimer disease is a chronic, progressive, and irreversible neurodegenerative disorder and the most common cause of dementia in older adults. It leads to gradual neuronal loss, causing cognitive decline, behavioral changes, and loss of functional independence.Risk Factors and EtiologyThe disease is multifactorial. Age is the strongest risk factor, with prevalence doubling every 5 years after age 65. Genetic factors include mutations in genes such as APP, PSEN1, and PSEN2, which are associated...
Alzheimer's Disease: Overview01:26

Alzheimer's Disease: Overview

Alzheimer's Disease (AD) is a continually advancing neurodegenerative disorder, distinguished by escalating memory loss, cognitive dysfunction, and dementia. The disease unfolds in three stages: preclinical, mild cognitive impairment (MCI), and dementia. Its onset is insidious, and the progression gradual, with the cause not well explained by other disorders.
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ and tau...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
Hemorrhagic Stroke l: Introduction01:17

Hemorrhagic Stroke l: Introduction

A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...