[Vascular dementia: the dubious disease].
Vascular dementia is not a disease or even a clearly defined disorder. It is a construct, which brings together very heterogeneous disturbances at the clinical, pathological and etiological levels. Due to the absence of neuropathologic diagnostic criteria, the frequency of associated degenerative pathology (mainly of Alzheimer type), and the heterogeneity of the construct, its clinical diagnosis remains questionable using various diagnostic criteria. The concept of vascular cognitive impairment (VCI) has been proposed as a substitute for vascular dementia to provide some clarification about the relationship between ischemic brain lesions and cognitive dysfunction. Its main interest is to allow diagnosis and treatment of minor cognitive deficits associated with ischemic brain lesions before the occurrence of dementia. Clinical and neuropsychological manifestations of VCI are of fronto-subcortical type, quite distinct from those of Alzheimer's disease. From a practical point of view, the main point is to find out and to treat the vascular risk factors which cause cognitive deficits by themselves or increase those associated with Alzheimer's disease.
Derouesné
Christian
C
Université Paris VI, Faculté de médecine Pitié-Salpêtrière, Paris. chderou@noos.fr
D001157:Arterial Occlusive Diseases / Q000150:complications / Q000473:pathology; D001921:Brain / Q000098:blood supply / Q000473:pathology; D002545:Brain Ischemia / Q000150:complications; D003072:Cognition Disorders / Q000175:diagnosis; D015140:Dementia, Vascular / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D006801:Humans