Vascular Dementia

Excerpt

Vascular dementia is among the most common etiologies of major neurocognitive disorder (MND), affecting primarily older adults (>65), and it is the leading nondegenerative cause of dementia. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) subsumes all dementing diseases under the syndromic term MND. MND requires an acquired decline in one or more cognitive domains, eg, attention, memory, executive function, language, or visuospatial ability, and a decline in functional independence.

Cardiovascular risk factors—smoking, hypertension, hyperlipidemia, diabetes, and atrial fibrillation—commonly underlie vascular dementia. Diagnosis relies upon a thorough history and physical/neurologic (including mental status) examination. Neuroimaging increases the precision of the diagnosis. Treatment is supportive in the ongoing absence of disease-modifying medications for vascular dementia approved by regulatory bodies.