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Updated: Jul 25, 2026
09:17
Using Retinal Imaging to Study Dementia
Published on: November 6, 2017
Vascular dementia: still a debatable entity?
Journal of the Neurological Sciences
|November 1, 1996
Summary
Vascular dementia (VAD) is a significant cause of cognitive decline, particularly in Asia. Diagnosis requires a multi-step approach including cognitive assessment, stroke risk evaluation, and neuroimaging to identify vascular lesions.
Area of Science:
- Neurology
- Neuroscience
- Geriatrics
Background:
- Vascular dementia (VAD) is the second leading cause of dementia in Europe and the USA, but more prevalent than Alzheimer's type dementia (DAT) in Asia.
- VAD diagnosis is complex, requiring a systematic approach to differentiate it from other dementias and pseudo-dementia.
Purpose of the Study:
- To outline the diagnostic criteria and subtypes of Vascular Dementia (VAD).
- To emphasize the importance of neuroimaging and neuropsychological assessment in VAD diagnosis.
- To highlight the prevalence and etiological factors of VAD.
Main Methods:
- Clinical diagnostic workup involving quantitative cognitive assessment, stroke risk factor identification, and neuroimaging (MRI, CT, PET, SPECT).
- Exclusion of other dementia causes and differential diagnosis against Alzheimer's type dementia (DAT).
- Identification of temporal causality between dementia onset and cerebral vascular lesions.
Main Results:
- VAD diagnosis necessitates clear cognitive deficits and evidence of cerebral vascular lesions via neuroimaging.
- Eight subtypes of VAD are identified, including multi-infarct dementia, strategically placed infarctions, lacunar lesions, Binswanger's disease, hemorrhagic lesions, and CADASIL.
- VAD is present in 30-70% of post-stroke patients, with complex and not fully understood cognitive impairment mechanisms.
Conclusions:
- Vascular dementia (VAD) diagnosis is a clinical determination supported by neuroimaging evidence of vascular lesions.
- Accurate diagnosis of VAD requires a comprehensive evaluation, including neuropsychological testing.
- Further research is needed to fully understand the mechanisms underlying cognitive impairments in VAD.
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