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Vascular dementia. Advances in nosology, diagnosis, treatment and prevention

G C Román1

  • 1Department of Medicine/Neurology, University of Texas Health Science Center at San Antonio and the Audie Murphy Veterans Administration Hospital, San Antonio, TX 78229-3900, USA. romang@uthscsa.edu

Panminerva Medica
|May 7, 2005
PubMed

Insights

Vascular dementia (VaD) results from cerebrovascular disease (CVD) damaging brain areas. Controlling vascular risk factors, especially hypertension, may prevent VaD and cognitive decline.

Area of Science:

  • Neurology
  • Vascular Medicine
  • Cognitive Science

Background:

  • Cerebrovascular disease (CVD) injures brain regions crucial for executive function, behavior, and memory, leading to cognitive decline and vascular dementia (VaD).
  • Cardiovascular disease can cause VaD through hypoperfusion, and may exacerbate degenerative dementias like Alzheimer's disease (AD).
  • Vascular cognitive disorder (VCD) is the diagnostic category for cognitive impairment of vascular origin, encompassing vascular cognitive impairment (VCI) and VaD.

Purpose of the Study:

  • To review the causes, risk factors, diagnostic markers, and potential prevention strategies for vascular dementia (VaD).
  • To differentiate between vascular cognitive impairment (VCI) and vascular dementia (VaD) within the spectrum of vascular cognitive disorder (VCD).

Main Methods:

  • Literature review of cerebrovascular disease, cognitive decline, and vascular dementia.
  • Analysis of risk factors associated with VaD development.
  • Review of current research on biomarkers for VaD and related conditions.
  • Examination of therapeutic approaches, including acetylcholinesterase inhibitors.

Main Results:

  • Identified numerous risk factors for VaD, including age, hypertension, diabetes, smoking, and various cardiovascular conditions.
  • Biomarker research indicates increased CSF-NFL and normal CSF-tau in VaD; CSF-TNF-alpha, VEGF, and TGF-beta are elevated in both AD and VaD.
  • Low CSF acetylcholinesterase levels are characteristic of VaD, which responds to acetylcholinesterase inhibitors, suggesting a cholinergic deficit.

Conclusions:

  • Vascular dementia (VaD) is a significant consequence of cerebrovascular disease (CVD) affecting cognitive functions.
  • Effective management of vascular risk factors, particularly hypertension, is strongly suggested as a primary prevention strategy for VaD.
  • Cholinergic deficits play a key role in VaD pathogenesis, with acetylcholinesterase inhibitors showing therapeutic potential.

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