Defining the diagnosis of vascular dementia.
Vascular dementia (VaD) is a heterogeneous term that has evolved to describe the behavioral syndromes associated with a variety of clinical and neuropathologic changes. As such, the VaD literature lacks a clear consensus regarding the neuropsychological and other constituent characteristics associated with various cerebrovascular changes. We address the issues articulated by Paul and colleagues (Paul, Garrett, & Cohen, 2003), by offering four recommendations to refine the clinical assessment and diagnostic decision-making process of individuals with suspected cerebrovascular changes: (a) Describing the nature of vascular changes may facilitate predictions regarding the neuropsychological profile of subtypes of VaD; (b) employ a process approach to assessment, measuring cognitive constructs in addition to test scores to describe the neuropsychological profiles of types of VaD; (c) integrate direct MRI observations of the brain and other collateral data in the diagnostic process; and (d) consider using "vascular cognitive impairment, no dementia" for suspected prodromal VaD.
Garrett
Kelly Davis
KD
Utah State University and LDS Hospital Neurospecialty Rehabilitation Unit, Salt Lake City, UT 84143-0001, USA. kelly@drexel.edu
Paul
Robert H
RH
Libon
David J
DJ
Cohen
Ron A
RA
D000368:Aged; D001519:Behavior; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology; D015140:Dementia, Vascular / Q000175:diagnosis* / Q000473:pathology / Q000523:psychology; D006801:Humans; D008279:Magnetic Resonance Imaging