VASCULAR DEMENTIA - A CONCISE CONCEPT

Although cerebrovascular diseases are the most common causes of dement ia after Alzheimer's disease, vascular dementia (VD) has remained so f ar an ill-defined term. The main problems in the definition of VD aris e from finding criteria for both terms ''vascular'' and ''dementia''. The detailed criteria for the diagnosis of VD proposed by several grou ps or institutions (ADDTC, DSM-IV, ICD-10, NINDS-ARIEN) are critically reviewed. The diagnostic value of some clinical findings, especially the very frequent white matter luciencies in CT (leuko-araiosis), are discussed. The available studies suggest a differentiation of VD into some subtypes (listed according to the frequency): subcortical VD, VD with acute onset, multiinfarct-elementia, mixed types, and specific fo rms. Nevertheless, these subtypes give only little information about t he etiology of the underlying vascular process and, therefore, no clea r indication for specific therapeutic strategies.