Vascular dementias in the elderly

In this review, challenging and controversial aspects of vascular dementias in the elderly are examined. Topical discussions underscore diagnostic criteria, epidemiology, clinical syndromes and diagnosis, prognosis and treatment. The need for a reappraisal of dementias with a shift from broad categorization to identification of specific vascular mechanisms that contribute to cognitive impairment and the need for more basic epidemiological studies are highlighted. With this information, a substantial scientifically-based approach to prevention and treatment can be undertaken.