Vascular Dementia

Question 1

Vascular Dementia Definition

Answer 1

• Not a single disease but a group of syndromes caused by different mechanisms (e.g. multiple infarcts, single strategic infarct, small vessel disease)
• Vascular cognitive impairment is spectrum of the deficit, VaD is most severe form of disease

Question 2

Vascular Dementia Aetiology

Answer 2

Main subtypes are

• Stroke related: incl. multi infarct and single infarct
• Subcortical: small vessel disease
• Mixed: Alzheimer’s and VaD changes, can co-exist

Question 3

Vascular Dementia Epidemiology

Answer 3

• Second most common form of dementia

- Prevalence of VaD following stroke depends on location and size of infarct

Question 4

Vascular Dementia Presentation

Answer 4

-Stepwise manner, presentation varies significantly

Features that suggest a vascular cause include:

• Focal neurological abnormalities
• Difficulty with attention and concentration
• Seizures
• Depression/anxiety
• Bladder symptoms
• Pseudobulbar palsy

Question 5

Vascular Dementia Diagnosis

Answer 5

• Comprehensive H/E, formal screening, medication review
• Exclude organic causes
• MRI
• Identify depression

Question 6

Vascular Dementia Management

Answer 6

• As for dementia
• Anticoagulation/antiplatelet therapy
• Prognosis is poor