Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.
Biomedical Research Building, Institute of Neuroscience and Newcastle University Institute for Ageing, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK.
Lancet. 2015 Oct 24;386(10004):1698-706. doi: 10.1016/S0140-6736(15)00463-8.
Vascular dementia is one of the most common causes of dementia after Alzheimer's disease, causing around 15% of cases. However, unlike Alzheimer's disease, there are no licensed treatments for vascular dementia. Progress in the specialty has been difficult because of uncertainties over disease classification and diagnostic criteria, controversy over the exact nature of the relation between cerebrovascular pathology and cognitive impairment, and the paucity of identifiable tractable treatment targets. Although there is an established relation between vascular and degenerative Alzheimer's pathology, the mechanistic link between the two has not yet been identified. This Series paper critiques some of the key areas and controversies, summarises treatment trials so far, and makes suggestions for what progress is needed to advance our understanding of pathogenesis and thus maximise opportunities for the search for new and effective management approaches.
血管性痴呆是仅次于阿尔茨海默病的第二大常见痴呆类型，约占所有痴呆病例的 15%。然而，与阿尔茨海默病不同，目前还没有针对血管性痴呆的获批治疗方法。由于疾病分类和诊断标准存在不确定性、脑血管病理与认知障碍之间的确切关系存在争议以及可识别的治疗靶点稀缺等原因，该领域的进展一直较为困难。虽然血管性和退行性阿尔茨海默病病理之间存在已确立的关系，但两者之间的机制联系尚未确定。本系列论文对一些关键领域和争议进行了评估，总结了迄今为止的治疗试验，并就需要取得哪些进展以增进我们对发病机制的理解从而最大程度地寻找新的有效管理方法提出了建议。
