Vascular dementia

Abstract

Vascular dementia is a chronic, progressive brain disease. Commonly seen problems include changes in cognition, motor function, mood and behaviour. These result from loss of brain parenchyma, most commonly from cerebrovascular diseases such as infarction and small vessel disease. Vascular dementia is the second most common type of dementia, after Alzheimer's disease. An estimated 55 000 000 people worldwide are affected. Vascular dementia can co-exist with other forms of dementia. Risk factors for developing vascular dementia include hypertension, atrial fibrillation, previous brain infarcts and diabetes. Diagnosis of vascular dementia requires a detailed and structured approach to ensure the exclusion of alternative diagnoses for cognitive impairment. Management of patients with vascular dementia should involve the wider multi-disciplinary team to maintain patient safety and independence. Vascular dementia can be managed effectively in primary care, but referral to specialist services is appropriate if the diagnosis is uncertain.