[Subtype identification in vascular dementia. An important step towards more precise diagnosis and improved treatment]

Abstract

Until 1970, the definition of vascular dementia was unspecific and resulted in overdiagnosis of "atherosclerosis". It was replaced by an oversimplified definition based on the notion that vascular dementia is practically always a result of infarctions. However, since the beginning of the 1990s, the concept of vascular dementia has undergone re-evaluation. With the aid of brain imaging, the existence has been demonstrated of circulation-related cerebral tissue changes other than infarcts. It is now clear that vascular dementia is a heterogeneous entity possible to subtype. One of the subtypes is subcortical white-matter dementia, which is perhaps more common than multi-infarct dementia. Subtype identification is a useful aid to reliable diagnosis, and in the long run it may prove helpful in improving treatment.