[Vascular dementia]

Abstract

Vascular dementia is one of the most frequently occurring dementia syndromes. Its prevalence is about 5% among subjects above 85 years of age. Elevated blood pressure and atherosclerosis are the most important risk factors. According to international criteria, vascular dementia usually occurs within three months after having a stroke. However, the diagnosis can be difficult as some strokes are clinically 'silent' and may go unnoticed. Other factors may also contribute to the dementia syndrome, and concomitant depression may mask its clinical picture. In population studies, treatment of vascular risk factors is associated with a relatively low incidence of vascular dementia, but this effect has not been investigated in a randomized clinical trial. The value of acetylsalicylic acid in attenuating cognitive deterioration in patients with vascular dementia is uncertain. Acetylcholinesterase inhibitors may slow down cognitive decline not only in some patients with Alzheimer's disease but also in patients with vascular dementia.