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  • Print publication year: 2019
  • Online publication date: June 2019

Chapter 7 - Vascular Dementia

Summary

Historically, the presence of vascular risk factors with imaging evidence of cerebral ischaemic/small vessel changes pointed towards a diagnosis of vascular dementia (VaD). This certainty, however, has been challenged by more recent evidence linking cerebrovascular risk factors readily attributed to VaD with the pathogenesis of Alzheimer’s disease (AD). Further diagnostic complication relates to the fact that the presence of cerebrovascular disease can also be encountered in other dementias and in those with no cognitive impairment. In one UK naturalistic memory clinic study, for example, more than 80% of patients diagnosed with AD (mean Hachinski Ischemic score < 1) had some evidence of cerebrovascular disease reported on their magnetic resonance imaging (MRI) brain scans [1]. Notwithstanding the challenges faced in diagnosing VaD and the heterogenous nature of the disorder, it is universally recognised that VaD is probably the second most common type of dementia after AD and remains a major public health problem [2].