title: Vascular dementia: a diagnosis running out of time.
abstract: BACKGROUND
  The concept of vascular dementia has a long history but its usefulness as a diagnostic category has been called into question.
  
  
  OBJECTIVE
  To evaluate vascular disease as a risk factor for dementia and the interface between cerebrovascular pathology and Alzheimer's disease.
  
  
  METHODS
  The literature on this topic was selectively reviewed and synthesised.
  
  
  RESULTS
  Risk factors for cerebrovascular disease are also risk factors for dementia. However, the course of dementia, once it has developed, appears to be frequently determined by Alzheimer's disease.
  
  
  CONCLUSIONS
  As a public health measure, modification of vascular risk represents a potentially powerful means to prevent dementia through delaying its onset. However, an effect on progression of dementia, once it has developed, has yet to be established. The traditional view of vascular dementia and Alzheimer's disease as distinguishable conditions is becoming steadily less tenable.
authors.affiliation: Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AF, UK. r.stewart@iop.kcl.ac.uk
authors.forename: Robert
authors.initials: R
authors.lastname: Stewart
mesh_terms: D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis; D015140:Dementia, Vascular / Q000175:diagnosis* / Q000209:etiology; D003937:Diagnosis, Differential; D006801:Humans; D012307:Risk Factors