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1 - Diagnosing vascular cognitive impairment and dementia: concepts and controversies

from Section 1 - Diagnosis

Published online by Cambridge University Press:  15 September 2009

Lars-Olof Wahlund
Affiliation:
Karolinska Institutet, Stockholm
Timo Erkinjuntti
Affiliation:
University of Helsinki
Serge Gauthier
Affiliation:
McGill University, Montréal
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Summary

Vascular cognitive impairment (VCI) is currently considered the most recent modification of the terminology to reflect the all-encompassing effects of vascular disease or lesions on cognition and incorporates the complex interactions between vascular etiologies, risk factors and cellular changes within the brain and cognition. The recognition of Alzheimer's disease (AD) as the commonest cause of dementia led to the development of operational criteria for the diagnosis of dementia in general. Post-stroke cognitive impairment is frequent, although it has been a neglected consequence of stroke. The main subtypes of vascular dementia (VaD) included in current classifications are cortical VaD or MID, also referred to as post-stroke VaD, subcortical ischemic vascular disease and dementia (SIVD) or small vessel dementia, and strategic infarct dementia. AD with cerebrovascular disease (CVD) can present clinically either as AD with evidence of vascular lesions upon brain imaging, or with clinical features of both AD and VaD.
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Publisher: Cambridge University Press
Print publication year: 2009

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