STATUS OF RISK-FACTORS FOR VASCULAR DEMENTIA

The two most common causes of vascular dementia (VAD) are dementia evo lving in connection with multiple small or large strokes and dementia related to ischemic white-matter lesions (WMLs) of the brain. The know ledge about risk factors for these disorders is still scarce. Besides sharing risk factors with stroke, dementia with multiple small or larg e brain infarcts is also associated with non-vascular risk factors suc h as high alcohol consumption, psychological stress in early life, low er formal education, blue collar occupation, and occupational exposure s. Risk factors for dementia in stroke victims include stroke-related and non-stroke related risk factors. Non-stroke-related factors are si milar to those found in Alzheimer's disease, The main risk factors for ischemic WMLs are hypertension or increased blood pressure, but WMLs have also been associated with a number of other vascular risk factors . In recent years, Alzheimer's disease (PLD) has also been reported to be associated with vascular risk factors, including hypertension, cor onary heart disease, atrial fibrillation, diabetes mellitus, and WMLs. Although these associations may reflect an overdiagnosis of AD in cas es with silent cerebrovascular disease, sr that cerebrovascular diseas e increases the possibility that individuals with Alzheimer lesions wi ll express a dementia syndrome, there are also alternative explanation s. AD and cerebrovascular disease may for instance share similar risk factors or etiologic pathways. The pathogenetic implications for the a ssociation between AD and vascular factors need to be further explored . There is also a need for more studies on risk factors for VAD and ri sk factors for dementia in stroke samples, as well as studies on nonva scular risk factors for ischemic WMLs.