Stroke and dementia.

OBJECTIVE

The current review covers causes and risk factors of vascular dementia, including single infarct, multi-infarct and cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy. Comparisons and distinctions are made between vascular dementia and Alzheimer's dementia, including shared vascular features and risk factors, differential diagnosis based on presenting history, neuropsychological testing results and neuroimaging findings. Neuropsychological findings associated with vascular dementia are discussed, and efforts towards stroke prevention and limiting the recurrence of stroke, as well as emerging treatment possibilities for cognitive decline associated with vascular dementia, are presented.

METHODS

A PubMed-based literature review was performed to acquire recent peer-reviewed publications on vascular dementia.

RESULTS

Stroke is one of the leading causes of disability, dementia and death. Within the USA, roughly 660,000 persons will experience a stroke each year. Although many individuals go on to demonstrate substantial improvement and recovery following stroke, a substantial percentage show residual effects including dementia. Vascular dementia has variable causes and manifestations, and research is revealing increasingly more common ground between vascular dementia and Alzheimer's dementia. However, vascular dementia often remains clinically distinct from Alzheimer's dementia, and profiles of neuropsychological impairment can be used to differentiate vascular dementia from the more common Alzheimer's dementia with some success.

CONCLUSION

Vascular dementia causes dependence and disability. Most stroke survivors show improvement, but many develop dementia. Understanding for vascular dementia has recently improved, leading to improved treatment planning. Further research, especially on treatment for vascular dementia, is greatly needed.