Classification and subtypes of vascular dementia

Area of Science:

• Neurology
• Neuroscience
• Clinical Medicine

Background:

• Vascular dementia (VaD) presents a broad clinicopathological spectrum, leading to classification challenges.
• Accurate identification of VaD subtypes is essential for effective diagnosis and research.
• Existing classifications hinder meaningful comparisons across studies due to heterogeneity.

Purpose of the Study:

• To propose clinically relevant and homogeneous subtypes of vascular dementia.
• To facilitate improved diagnostic processes and cross-study comparisons in VaD research.
• To identify specific subtypes that are readily identifiable and clinically useful.

Main Methods:

• Review and synthesis of existing literature on VaD classification.
• Identification and definition of proposed VaD subtypes based on clinical and pathological features.
• Suggestion of diagnostic criteria for proposed subtypes, including potential use of neuroimaging and biomarkers.

Main Results:

• Proposes three candidate subtypes for vascular dementia: poststroke dementia, subcortical VaD, and combined Alzheimer's disease and VaD (AD + VaD).
• Poststroke dementia and subcortical VaD are identified as relatively easy to diagnose.
• AD + VaD is more challenging but potentially identifiable with advanced diagnostic tools.

Conclusions:

• Homogeneous subtypes of VaD are proposed to aid clinical diagnosis and research.
• Poststroke dementia and subcortical VaD offer distinct, identifiable clinical profiles.
• Further research and validation are needed, particularly for identifying combined AD + VaD.