Updates in vascular dementia

Abstract

It has been more than a hundred years since Alzheimer and Binswanger's first description of vascular dementia (VaD). Ever since then, histopathology research and neuroimaging techniques have allowed the development of new pathogenic, etiologic, and treatment hypotheses. The “vascular cognitive impairment (VCI)” concept has also been developed, and it includes all grades of cognitive dysfunction of a vascular origin. Early detection of dementia as well as its primary prevention is the main goals for clinicians. For this reason, new scales, new diagnostic criteria, and preventive treatments have been proposed. The association between stroke and VaD is already known, but a comprehensive review of this relationship reveals a bidirectional causality. Depression has been hypothesized as a risk factor for later dementia development. Late-life depression is the most associated condition; however, studies have found it works as a prodromal state symptom. Deep knowledge in vascular risk factors that are involved in vascular origin cognitive decline is the most important prevention tool. Hypertension, Type II diabetes, cholesterol, and inflammation markers have demonstrated to increase the risk of VaD. Evidence supporting treatments for primary and secondary prevention of VaD and VCI are presented.

Keywords

• prevention
• risk factor
• vascular cognitive impairment
• vascular dementia