Vascular dementia: possible role of the ischemic lesions in mild dementia

Abstract

ABSTRACTUntil the first half of the 1980s, vascular disorders were the leading cause of dementia patients living in major cities of Japan; at present, Alzheimer's disease is the most common cause. The primary reason for the increase in the relative incidence of dementia due to Alzheimer's disease is the decrease in the number of cases of vascular dementia due to primary and secondary prevention of cerebrovascular disorders. However, no drug can effectively prevent lacunar infarct and the incidence of infarcts in the deep cerebral white matter has not significantly decreased, the prevalence of elderly patients with Alzheimer's disease associated with cerebral infarct is rapidly increasing.The increased relative incidence of Alzheimer's disease in Japan is also attributable to increases in the number of elderly persons and number of patients diagnosed with mild dementia. The living environment of senior citizens in Japan has changed over the last few decades by advances in the level of technology commonly used in society and by increases in the number of nuclear families. Mildly demented patients with hippocampal atrophy and ischemic lesion were increased in number. However differentiating vascular dementia from Alzheimer's disease in elderly demented patients with hippocampal atrophy associated with ischemic lesions remains difficult, asymptomatic cerebral infarcts significantly affect frontal lobular function especially in elderly persons. Appropriate prevention and treatment of ischemia in these patients may help to reduce the number of dementia patients.