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31 - Vascular dementia

Published online by Cambridge University Press:  10 October 2009

By
Hugues Chabriat  and
Olivier Godefroy
Edited by
Olivier Godefroy  and
Julien Bogousslavsky
Hugues Chabriat
Affiliation:
University Hospital Lariboisière and IFR 49, Paris, France
Olivier Godefroy
Affiliation:
University Hospital, Amiens, France
Olivier Godefroy
Affiliation:
Université de Picardie Jules Verne, Amiens
Julien Bogousslavsky
Affiliation:
Université de Lausanne, Switzerland
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Summary

Introduction

Vascular dementia (VaD) is the second most common cause of dementia with a frequency ranging from 15% to 25% in autopsy and epidemiological studies (Tomlinson et al., 1970; Stevens et al., 2002). In addition, dementia is observed a few months post-stroke with prevalence as high as 25–33%, and about two-thirds of these patients meet the criteria of VaD (Tatemichi et al., 1993; Pohjasvaara et al., 1998). VaD may be a preventable type of dementia since it is due to vascular pathology and usually concerns patients with modifiable vascular risk factors. The diagnosis of VaD has several implications, including a high risk of stroke recurrence and mortality (Tatemichi et al., 1994b; Moroney et al., 1997b). VaD is due to several vascular pathologies, the most frequent being small vessel disease responsible for lacunes and leukoaraïosis (reported in about 40% of poststroke dementia) and multiple territorial infarcts. Because of the vascular mechanisms of underlying lesions, VaD is characterized by the frequency of stroke history, abrupt onset, stepwise deterioration, and the early presence of non-cognitive signs such as motor and perceptual deficits, gait disorders, speech and swallowing disorders, and incontinence. However a third of autopsy-confirmed VaD did not report stroke history and about a quarter presented with a progressive worsening (Moroney et al., 1997a). Although the neuropsychological pattern was found to be variable in an autopsy-confirmed VaD (Reed et al., 2004), most studies highlighted the prominence of executive dysfunction and response slowing.

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The Behavioral and Cognitive Neurology of Stroke , pp. 586 - 616
Publisher: Cambridge University Press
Print publication year: 2007

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  • Vascular dementia
  • Edited by Olivier Godefroy, Université de Picardie Jules Verne, Amiens, Julien Bogousslavsky, Université de Lausanne, Switzerland
  • Book: The Behavioral and Cognitive Neurology of Stroke
  • Online publication: 10 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544880.032
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  • Vascular dementia
  • Edited by Olivier Godefroy, Université de Picardie Jules Verne, Amiens, Julien Bogousslavsky, Université de Lausanne, Switzerland
  • Book: The Behavioral and Cognitive Neurology of Stroke
  • Online publication: 10 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544880.032
Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

  • Vascular dementia
  • Edited by Olivier Godefroy, Université de Picardie Jules Verne, Amiens, Julien Bogousslavsky, Université de Lausanne, Switzerland
  • Book: The Behavioral and Cognitive Neurology of Stroke
  • Online publication: 10 October 2009
  • Chapter DOI: https://doi.org/10.1017/CBO9780511544880.032
Available formats
×