A historical review of the concept of vascular dementia: Lessons from the past for the future

The history of senile dementia begins in the Greco-Roman period with basic concepts of senility by Pythagoras and Hippocrates. During the Middle Ages, the main contribution was by Roger Bacon in 1290. The first textbook of ne urology, De cerebri morbis, by Jaso de Pratis (1549), included a chapter on dementia ("De memoriae detrimento'). Tn the 17th century, Thomas Willis re cognized intellectual loss with aging. In the 19th century, Philippe Pinel removed chains from the mentally ill; his student Esquirol wrote the first modem classification of mental disease, including senile dementia. In 1860, Morel recognized brain atrophy with aging. The modem history of vascular d ementia began in 1896, when Emil Kraepelin in his textbook Psychiatrie incl uded "arteriosclerotic dementia" among the senile dementias, following the ideas of Otto Binswanger and Alois Alzheimer, who had differentiated clinic ally and pathologically arteriosclerotic brain lesions from senile dementia and from neurosyphilitic general paresis of the insane. Binswanger's and A lzheimer's contributions are reviewed in detail.