title: Vascular cognitive impairment in dementia.
abstract: Vascular risk factors and cerebrovascular disease are common causes of dementia. Shared risk factors for vascular dementia and Alzheimer's disease, as well as frequent coexistence of these pathologies in cognitively impaired older people, suggests convergence of the aetiology, prevention and management of the commonest dementias affecting older people. In light of this understanding, the cognitive impairment associated with cerebrovascular disease is an increasingly important and recognised area of the medicine of older people. Although the incidence of cerebrovascular events is declining in many populations, the overall burden associated with brain vascular disease will continue to increase associated with population ageing. A spectrum of cognitive disorders related to cerebrovascular disease is now recognised. Cerebrovascular disease in older people is associated with specific clinical and imaging findings. Although prevention remains the cornerstone of management, the diagnosis of brain vascular disease is important because of the potential to improve clinical outcomes through clear diagnosis, enhanced control of risk factors, lifestyle interventions and secondary prevention. Specific pharmacological intervention may also be indicated for some patients with cognitive impairment and cerebrovascular disease. However the evidence base to guide intervention remains relatively sparse.
authors.affiliation: Western Australian Centre for Health & Ageing (M573), Centre for Medical Research, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia; Department of Geriatric Medicine, Royal Perth Hospital, 197 Wellington Street, Perth, WA 6000, Australia. Electronic address: Christopher.etherton-beer@uwa.edu.au.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Etherton-Beer
mesh_terms: D000544:Alzheimer Disease / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D002544:Cerebral Infarction / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D002561:Cerebrovascular Disorders / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D003072:Cognition Disorders / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D015140:Dementia, Vascular / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000188:drug therapy / Q000453:epidemiology; D012307:Risk Factors; D040242:Risk Reduction Behavior; D055502:Secondary Prevention
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Brain ischaemia; Cerebral infarction; Cerebrovascular disorders; Dementia; Vascular