Cerebral hemodynamics and vascular dementia: Identifying opportunities for early intervention

Vascular dementia (VaD), unlike Alzheimer's disease, is often preventable and can be slowed down or halted with early intervention. VaD results from impaired cerebral blood flow due to conditions like atherosclerosis or Moyamoya disease, leading to repeated small strokes and, consequently, cognitive decline. VaD can exist separately or co-exist with Alzheimer's disease, with the latter commonly being of a more insidious onset and involving beta amyloid protein depositions in the brain. VaD may be missed due to the focus on treating the stroke symptoms, and sometimes be interpreted as normal age-related cognitive decline. Thus, patients with vascular risk factors, who present with acute or acute-on-chronic neurological deficits that co-exist with features of subtle memory or executive functional changes, should have prompt vascular evaluation using neuroimaging.