Pathophysiology of vascular dementia

The concept of Vascular Dementia (VaD) has been recognized for over a century, but its definitionand diagnostic criteria remain unclear.Conventional definitions identify the patients too late, miss subjects with cognitive impairmentshort of dementia, and emphasize consequences rather than causes, the true bases for treatmentand prevention. We should throw out current diagnostic categories and describe cognitiveimpairment clinically and according to commonly agreed instruments that document thedemographic data in a standardized manner and undertake a systematic effort to identify theunderlying aetiology in each case.Increased effort should be targeted towards the concept of and criteria for Vascular CognitiveImpairment and Post-Stroke Dementia as well as for genetic factors involved, especially as thesecategories hold promise for early prevention and treatment.