[Vascular dementia--an ill-defined concept].
BACKGROUND
Vascular dementia is defined as dementia caused by cerebrovascular disease and is seen as the most common cause of dementia after Alzheimer's disease. In our opinion, vascular dementia is an ill-defined term; this proposition is discussed in this article.


METHODS
The concept of vascular dementia is discussed based on the literature and our own clinical experience.


RESULTS
The prevalence of vascular dementia varies markedly across different studies and several clinical diagnostic criteria are used. There has been an ongoing debate as to which radiological changes are associated with vascular dementia; we question the use of neuropathological changes as a diagnostic gold standard. Several studies have shown similarities between dementia of the Alzheimer type and vascular dementia regarding risk factors and symptomatology.


CONCLUSIONS
We conclude that the concept of vascular dementia should be re-evaluated. It is important to establish valid and reliable criteria for vascular dementia, especially in the light of the therapeutic consequences.
Braekhus
Anne
A
Nevrologisk avdeling, Rikshospitalet, 0027 Oslo. anne.brakhus@rikshospitalet.no
Engedal
Knut
K
D000544:Alzheimer Disease / Q000175:diagnosis; D003210:Concept Formation; D015140:Dementia, Vascular / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology; D003937:Diagnosis, Differential; D006801:Humans; D015995:Prevalence; D012307:Risk Factors; D009626:Terminology as Topic