Vascular dementia Flashcards
What is the second most common form of dementia after Alzheimer’s disease?
Vascular dementia (VD).
What term encompasses the spectrum of deficits that includes vascular dementia?
Vascular cognitive impairment (VCI).
What is the underlying cause of vascular dementia?
Cognitive impairment due to ischaemia or haemorrhage secondary to cerebrovascular disease.
What percentage of dementia cases in the UK are attributed to vascular dementia?
Around 17%
How does stroke impact the risk of developing dementia?
Stroke doubles the risk of dementia
What are the three main subtypes of vascular dementia?
- Stroke-related VD (multi-infarct or single-infarct dementia)
- Subcortical VD (caused by small vessel disease)
- Mixed dementia (coexistence of VD and Alzheimer’s disease).
Name five major risk factors for vascular dementia.
- History of stroke or TIA
- Atrial fibrillation
- Hypertension
- Diabetes mellitus
- Hyperlipidaemia
What rare inherited condition is associated with vascular dementia?
CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy).
What is the typical presentation of vascular dementia?
Stepwise cognitive decline over several months or years, often following a cerebrovascular event.
Name three common symptoms of vascular dementia.
- Focal neurological abnormalities (e.g., visual, sensory, or motor symptoms)
- Memory disturbance
- Gait disturbance
What criteria does NICE recommend for diagnosing probable vascular dementia?
NINDS-AIREN criteria.
What imaging modality is preferred for diagnosing vascular dementia?
MRI scan (shows infarcts and extensive white matter changes).
What are the key elements of the NINDS-AIREN criteria for vascular dementia?
- Cognitive decline affecting daily activities
- Evidence of cerebrovascular disease (neurological signs and/or imaging)
- A clear relationship between cognitive impairment and cerebrovascular disease
What pharmacological treatments are considered for vascular dementia?
Acetylcholinesterase inhibitors or memantine only if there is suspected comorbid Alzheimer’s disease, Parkinson’s disease dementia, or dementia with Lewy bodies.
Name two non-pharmacological management strategies for vascular dementia.
- Cognitive stimulation programmes
- Music and art therapy
Is aspirin effective in treating vascular dementia?
No, there is no evidence supporting its use
Do statins have proven benefits in vascular dementia?
No randomized trials support the use of statins for vascular dementia.
What is the main goal of vascular dementia management?
Symptomatic treatment, risk factor control, and patient/carer support.
