Chapter 2 - Vascular dementia: an overview

Abstract

Vascular dementia is claimed to be the second most common cause of dementia, accounting for ∼15%–20% of cases. Clinical diagnosis is challenging because with the term “vascular dementia” we consider different vascular pathologies, such as multiinfarct dementia, small vessel disease, strategic infarct dementia, hypoperfusion dementia, hemorrhagic dementia, hereditary vascular dementia, and Alzheimer's disease with cardiovascular disease. Nowadays there is still a lack of consensus regarding disease classification and diagnostic criteria. Although there has been much progress in defining and understanding the relation between cerebrovascular disease and dementia, some uncertainties remain. There is a lot of evidence supporting an interaction between Alzheimer's and vascular pathology, but the relation between the two pathologies has not yet been completely understood. For the correct management of vascular dementia, primary and secondary prevention measures for the causative cerebrovascular disease, such as vascular risk factors intervention and antiplatelet and anticoagulation therapies, are important. However, unlike Alzheimer's disease, there are no established symptomatic treatments for cognitive impairment.