Vascular dementia

Vascular disease is the most common treatable cause of dementia. Contemporary epidemiological models suggest that in developed Western societies, vascular disease alone accounts for about 15% of all dementia. In association with Alzheimer’s disease, however, it is suspected to be involved in at least 50% of all dementia. Recent research points to shared risk factors in vascular dementia and Alzheimer’s disease, and common pathogenetic processes are likely.
The exact criteria required for a diagnosis of vascular dementia remain imprecise and poorly developed. Advances in brain structural and functional imaging provide the best prospects for improvement in vascular dementia diagnosis.
Here we set out the major processes that impinge upon the health of neurones and may contribute to vascular dementia. Clinical trials of interventions that might slow progression of cognitive impairment to vascular dementia are fully justified and are likely to improve the care of many old people at particular risk of dementia.