Vascular Dementia: Cerebrovascular Mechanisms and Clinical Management. Robert H. Paul, Ronald Cohen, Brian R. Ott, and Stephen Salloway (Eds.). 2004. Totowa, NJ: Humana Press, 356 pp., $145.00, £91.00 (HB).

Interest in how vascular factors contribute to dementia is ascendant, propelled by a number of factors. One is the widespread use of MRI, which is a highly sensitive (if not always specific) test for cerebrovascular lesions. A second is a string of epidemiological reports revealing that Alzheimer's disease shares many of the well established risk factors for cardiovascular and cerebrovascular disease (Skoog & Gustafson, 2003). Recent autopsy studies using cohorts obtained outside of the potentially winnowing influence of the Alzheimer's disease centers have reminded us that vascular lesions are common in patients with dementia (Neuropathology Group of the Medical Research Council Cognitive Function and Ageing Study, 2001). The Nun study report suggesting that infarcts create an additive or greater effect on mental function in concert with AD pathology (Snowdon et al., 1997) received particularly wide exposure and helped revive interest in combined effects of AD and ischemic lesions. Finally, the discovery that polymorphisms of the apoE gene, long of interest in cardiovascular disease, strongly modify the risk of AD suggested the possibility of shared pathophysiological mechanisms between AD and vascular dementia (Panza et al., 2004; Strittmatter & Roses, 1995). The volume Vascular Dementia, edited by Paul, Cohen, Ott and Salloway, is thus a timely resource for those interested in the numerous issues surrounding the role of vascular factors in dementia.