Vascular Dementia (20%)

Question 1

Pathophysiology

Answer 1

Reduced blood flow to the brain, secondary to small or large vessel disease
E.g. cerebrovascular damage e.g. stroke, TIA

Question 2

Clinical features

Answer 2

Step wise decline in cognitive function
Evidence of previous stroke
Depression and delusions
Emotional lability
Memory impairment
Gait disturbance and incontinence are sometimes seen

Question 3

Treatment

Answer 3

Optimise cardiovascular risk factors: to reduce the likelihood of further ischaemic events
Antihypertensives e.g. RAMIPRIL
AChE inhibitor or memantine: if there is suspected comorbid Alzheimer’s disease, Dementia with Lewy-Bodies or Parkinson’s disease

Question 4

Risk factors

Answer 4

Smoking
Diabetes
AF
Dyslipidaemia
Hypertension
Age