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(Stroke. 2008;39:783.)
© 2008 American Heart Association, Inc.

Original Contributions

Assessing the Impact of Vascular Disease in Demented and Nondemented Patients

David J. Libon, PhD Kenneth M. Heilman, MD

From the Department of Neurology (D.J.L.), Drexel University College of Medicine, Philadelphia, Pa; Department of Neurology (K.M.H.), University of Florida, Gainesville, Fla; and Veteran Affairs Medical Center (K.M.H.), Gainesville, Fla.

Correspondence to David J. Libon, Department of Neurology, Drexel University College of Medicine, New College Building, Mail Stop 423 245 North Broad St, Philadelphia, PA 19102. E-mail dlibon@drexelmed.edu

Key Words: dementia • vascular dementia

An extract of the first 250 words of the full text is provided, because this article has no abstract.

That vascular diseases can induce dementia has been known for more than a century. For example, in the 19th and early 20th centuries, the major differential diagnosis of patients with dementia was neurosyphilis versus vascular disease. Also, it is a little known fact that Alzheimer himself wrote 5 articles on vascular dementia and that many of Alzheimer’s observations with respect to vascular dementia subtypes, and the effect of vascular disease on behavior and cognition, have withstood the test of time.¹

For a few decades interest in vascular dementia (VaD) waned, but there is now keen interest in how cerebrovascular disease influences cognition. Beginning in the early 1990s, new algorithms for the diagnosis of VaD were developed and proposed.^2,3 However, subsequent research has shown that the relationships between Alzheimer disease (AD) and VaD are far more complex than previously believed.^4,5 For example, risk factors traditionally associated with stroke/VaD are now also considered risk factors for AD. Numerous longitudinal, population-based studies have demonstrated links between vascular risk factors, such as atherosclerosis,⁶ diabetes,⁷ hyperlipidemia,⁸ and stroke⁹ and the development of AD. Although AD and VaD are usually associated with different forms of cognitive impairments (eg, declarative memory and executive control, respectively), investigators have reported considerable overlap in the neuropathological and the neuropsychological profiles of these syndromes.^10,11 Much works needs to be done to better delineate and characterize these two common dementia syndromes.The role of vascular disease in producing various forms of cognitive impairment still needs to be better elucidated.

The purpose of this . . . [Full Text of this Article]

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