Rethinking Vascular Dementia (Part 1 of 2)

Vascular dementia is growing in importance, so is the confusion surrounding it. Vascular dementia may be regarded as a syndrome of cognitive impairment resulting from vascular diseases, especially ischemic brain changes. It may be related to many different vascular mechanisms, types of brain changes and risk factors. However, currently no precise knowledge exists regarding the extent to which these factors cause, contribute or only coincide with the cognitive loss. The resulting imprecision in definition and diagnosis breeds confusion regarding prevention, treatment and incidence of the syndrome. In addition, the changing patterns of age of the population, risk factors and types of stroke complicate the clinical picture. Instead of comfortable categorization, the emphasis needs to be shifted to identifying and understanding the interactive vascular factors that contribute to cognitive impairment. This may open avenues in the search for modifiable and treatable vascular components.