Vascular dementia

Question 1

what is the definition of vascular dementia?

Answer 1

Vascular dementia is a chronic progressive disease of the brain bringing about cognitive impairment. The executive functions of the brain such as planning are more prominently affected than memory. Motor and mood changes are often seen early. The underlying damage occurs to both grey matter and white matter from predominantly vascular causes: that is, infarction, leukoaraiosis, haemorrhage, and small-vessel changes. Mixed dementia (vascular dementia with comorbid Alzheimer’s disease) is common

Question 2

what is the epidemiology of vascular dementia?

Answer 2

Vascular dementia is the second most common cause of dementia in older people.
A large overlap exists with Alzheimer’s dementia and many patients have a mixed form of dementia.

Question 3

what is the aetiology of vascular dementia?

Answer 3

Loss of brain parenchyma is predominantly from cerebrovascular causes such as infarction and small-vessel changes.

Question 4

what are the risk factors for vascular dementia?

Answer 4

age >60 years
obesity
hypertension
cigarette smoking

Question 5

what are the key presentations for vascular dementia?

Answer 5

Vascular dementia is characterised by a chronic progressive multifaceted impairment of cognitive function.
history of stroke(s)
difficulty solving problems
apathy
disinhibition

Question 6

what are the first line and gold standard investigations for vascular dementia?

Answer 6

FBC
erythrocyte sedimentation rate
blood glucose level
renal and liver function tests