Skip to main content

Advertisement

SpringerLink
Log in

Vascular dementia: A review of recent evidence for prevention and treatment

  • Published:
Current Neurology and Neuroscience Reports Aims and scope Submit manuscript

Abstract

Vascular dementia is a common cause of late-life cognitive decline. Vascular risk factors, transient is chemic attacks, silent and clinically evident strokes, and ischemic changes on brain imaging studies are all associated with the development of dementia. Prevention of vascular dementia involves treatment of risk factors and the same preventive measures used to avoid heart attacks and strokes. Other treatments for vascular dementia, although promising, remain unproved.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References and Recommended Reading

  1. Roman GC: On the history of lacunes, etat crible, and the white matter lesions of vascular dementia. Cerebrovasc Dis 2002, 13(Suppl 2):1–6.

    PubMed  Google Scholar 

  2. Zhang-Nunes SX, Maat-Schieman ML, van Duinen SG, et al.: The cerebral beta-amyloid angiopathies: hereditary and sporadic. Brain Pathol 2006, 16:30–39.

    Article  CAS  PubMed  Google Scholar 

  3. Hachinski VC, Iliff LD, Zilkha E, et al.: Cerebral blood flow in dementia. Arch Neurol 1975, 32:632–637.

    CAS  PubMed  Google Scholar 

  4. Rosen WG, Terry RD, Fuld PA, et al.: Pathological verification of ischemic score in differentiation of dementias. Ann Neurol 1980, 7:486–448.

    Article  CAS  PubMed  Google Scholar 

  5. Hachinski V: Vascular dementia: a radical redefinition. Dementia 1994, 5:130–132.

    CAS  PubMed  Google Scholar 

  6. Chui HC, Victoroff JI, Margolin D, et al.: Criteria for the diagnosis of ischemic vascular dementia proposed by the State of California Alzheimer’s Disease Diagnostic and Treatment Centers. Neurology 1992, 42:473–480.

    CAS  PubMed  Google Scholar 

  7. Roman GC, Tatemichi TK, Erkinjuntti T, et al.: Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Work Group. Neurology 1993, 43:250–260.

    CAS  PubMed  Google Scholar 

  8. Knopman D, Boland LL, Mosley T, et al.: for the Atherosclerosis Risk in Communities (ARIC) Study Investigators: Cardiovascular risk factors and cognitive decline in middleaged adults. Neurology 2001, 56:42–48.

    CAS  PubMed  Google Scholar 

  9. Forette F, Seux ML, Staessen JA, et al.: Prevention of dementia in randomised double-blind placebo-controlled Systolic Hypertension in Europe (Syst-Eur) trial. Lancet 1998, 352:1347–1351.

    Article  CAS  PubMed  Google Scholar 

  10. Hanon O, Forette F: Prevention of dementia: lessons from SYST-EUR and PROGRESS. J Neurol Sci 2004, 226:71–74.

    Article  PubMed  Google Scholar 

  11. Yaffe K, Kanaya A, Lindquist K, et al.: The metabolic syndrome, inflammation, and rise of cognitive decline. JAMA 2004, 292:2237–2242.

    Article  CAS  PubMed  Google Scholar 

  12. Solomon A, Kareholt I, Ngandu T: Serum cholesterol changes after mid-life and late-life cognition: twenty-one year follow-up. Neurology 2007, 68:751–756.

    Article  CAS  PubMed  Google Scholar 

  13. Shumaker SA, Legault C, Rapp SR, et al.: Estrogen plus progestin and the incidence of dementia and mild cognitive impairment in postmenopausal women. The Women’s Health Initiative Memory Study: a randomized controlled trial. JAMA 2003, 289:2651–2652.

    Article  CAS  PubMed  Google Scholar 

  14. Rapp SR, Espeland MA, Shumaker SA: Effect of estrogen plus progestin on global cognitive function in post menopausal women. The Women’s Health Initiative Memory Study: a randomized controlled trial. JAMA 2003, 289:2663–2672.

    Article  CAS  PubMed  Google Scholar 

  15. Bos MJ, Van Rijn MJ, Witteman JC, et al.: Incidence and prognosis of transient neurological attacks. JAMA 2007, 298:2877–2785.

    Article  CAS  PubMed  Google Scholar 

  16. Tatemichi TK, Paik M, Bagiella E, et al.: Risk of dementia after stroke in a hospitalized cohort: results of a longitudinal study. Neurology 1994, 44:1885–1891.

    CAS  PubMed  Google Scholar 

  17. Kokmen E, Whisnant JP, O’Fallon WM, et al.: Dementia after ischemic stroke: a population-based study in Rochester, Minnesota (1960-1984). Neurology 1996, 46:154–159.

    CAS  PubMed  Google Scholar 

  18. Pohjasvaara T, Mantyla R, Salonen O, et al.: How complex interactions of ischemic brain infarcts, white matter lesions, and atrophy relate to poststroke dementia. Arch Neurol 2000, 57:1295–1300.

    Article  CAS  PubMed  Google Scholar 

  19. Stebbins GT, Nyenhuis DL, Wang C, et al.: Gray matter atrophy in patients with ischemic stroke with cognitive impairment. Stroke 2008, 39:785–793.

    Article  PubMed  Google Scholar 

  20. Szirmai I, Vastagh I, Szombathelyi E, Kamondi A: Strategic infarcts of the thalamus in vascular dementia. J Neurol Sci 2002, 203-204:91–97.

    Article  PubMed  Google Scholar 

  21. Williamson JB, Nyenhuis DL, Pedelty L, et al.: Baseline differences between vascular cognitive impairment no dementia reverters and non-reverters. J Neurol Neurosurg Psychiatry 2008, 79:1208–1214.

    Article  CAS  PubMed  Google Scholar 

  22. Leary MC, Saver JL: Annual incidence of first silent stroke in the United States: a preliminary estimate. Cerebrovasc Dis 2003, 16:280–285.

    Article  PubMed  Google Scholar 

  23. Vermeer SE, Prins ND, den Heijer T, et al.: Silent brain infarcts and the risk of dementia and cognitive decline. N Engl J Med 2003, 348:1215–1222.

    Article  PubMed  Google Scholar 

  24. Hachinski VC, Potter P, Merskey H: Leuko-araiosis. Arch Neurol 1987, 44:21–23.

    CAS  PubMed  Google Scholar 

  25. Steingart A, Hachinski VC, Lau C, et al.: Cognitive and neurologic findings in subjects with diffuse white matter lucencies on computed tomographic scan (leuko-araiosis). Arch Neurol 1987, 44:32–35.

    CAS  PubMed  Google Scholar 

  26. Kertesz A, Polk M, Carr T: Cognition and white matter changes on magnetic resonance imaging in dementia. Arch Neurol 1990, 47:387–391.

    CAS  PubMed  Google Scholar 

  27. Breteler MMB, van Swieten JC, Bots ML, et al.: Cerebral white matter lesions, vascular risk factors, and cognitive function in a population-based study: the Rotterdam Study. Neurology 1994, 44:1246–1252.

    CAS  PubMed  Google Scholar 

  28. Moser DJ, Cohen RA, Paul RH, et al.: Executive function and magnetic resonance imaging subcortical hyperintensities in vascular dementia. Neuropsychiatry Neuropsychol Behav Neurol 2001, 14:89–92.

    CAS  PubMed  Google Scholar 

  29. McPherson SE, Cummings JL: Neuropsychological aspects of vascular dementia. Brain Cogn 1996, 31:269–282.

    Article  CAS  PubMed  Google Scholar 

  30. Reed BR, Mungas DM, Kramer JH, et al.: Profiles of neuropsychological impairment in autopsy-defined Alzheimer’s disease and cerebrovascular disease. Brain 2007, 130:731–739.

    Article  PubMed  Google Scholar 

  31. Knopman DS, Parisi DS, Boeve BF, et al.: Vascular dementia in a population-based autopsy study. Arch Neurol 2003, 60:569–575.

    Article  PubMed  Google Scholar 

  32. Schneider JA, Boyle PA, Arvanitakis Z, et al.: Subcortical infarcts, Alzheimer’s disease pathology, and memory function in older persons. Ann Neurol 2007, 62:59–66.

    Article  PubMed  Google Scholar 

  33. Kovari E, Gold G, Herrmann FR, et al.: Cortical microinfarcts and demyelination affect cognition in cases at high risk for dementia. Neurology 2007, 68:927–931.

    Article  CAS  PubMed  Google Scholar 

  34. Chui H, Zarow C, Mack WJ, et al.: Cognitive impact of subcortical vascular and Alzheimer’s disease pathology. Ann Neurol 2006, 60:677–687.

    Article  PubMed  Google Scholar 

  35. Seo SW, Lee BH, Kim E-J, et al.: Clinical significance of microbleeds in subcortical vascular dementia. Stroke 2007, 38:1949–1951.

    Article  Google Scholar 

  36. Viswanathan A, Chabriat H: Cerebral microhemorrhages. Stroke 2006, 37:550–555.

    Article  PubMed  Google Scholar 

  37. Vagnucci AH Jr, Li WW: Alzheimer’s disease and angiogenesis. Lancet 2003, 361:605–608.

    Article  CAS  PubMed  Google Scholar 

  38. Wu Z, Guo H, Chow N, et al.: Role of the MEOX2 homeobox gene in neurovascular dysfunction in Alzheimer’s disease. Nat Med 2005, 11:899–904.

    Article  PubMed  Google Scholar 

  39. Dichgans M, Mayer M, Uttner I, et al.: The phenotypic spectrum of CADASIL: clinical findings in 102 cases. Neurology 1998, 44:731–739.

    CAS  Google Scholar 

  40. Jouvent E, Viswanathan A, Mangin JF, et al.: Brain atrophy is related to lacunar lesions and tissue microstructural changes in CADASIL. Stroke 2007, 38:1786–1790.

    Article  PubMed  Google Scholar 

  41. Caplan LR, Schoene WC: Clinical features of subcortical arteriosclerotic encephalopathy (Binswanger disease). Neurology 1978, 28:1206–1215.

    CAS  PubMed  Google Scholar 

  42. Babikian V, Ropper AH: Binswanger’s disease: a review. Stroke 1987, 18:1–12.

    Google Scholar 

  43. Beal MF, Williams RS, Richardson EP, Fisher CM: Cholesterol embolism as a cause of transient ischemic attacks and cerebral infarction. Neurology 1981, 31:860–865.

    CAS  PubMed  Google Scholar 

  44. Sneddon IB: Cerebro-vascular lesions and livedo reticularis. Br J Dermatol 1965, 77:180–185.

    Article  CAS  PubMed  Google Scholar 

  45. Wright RA, Kokmen E: Gradually progressive dementia without discrete cerebrovascular events in a patient with Sneddon’s syndrome. Mayo Clin Proc 1999, 74:57–61.

    Article  CAS  PubMed  Google Scholar 

  46. Moore PM, Richardson B: Neurology of the vasculitides and connective tissue diseases. J Neurol Neurosurg Psychiatry 1998, 65:10–22.

    Article  CAS  PubMed  Google Scholar 

  47. Fieschi C, Rasura M, Anzini A, Beccia M: Central nervous system vasculitis. J Neurol Sci 1998, 8:159–171.

    Article  Google Scholar 

  48. Kirk A, Kertesz A, Polk MJ: Dementia with leukoencephalopathy in systemic lupus erythematosus. Can J Neurol Sci 1991, 18:344–348.

    CAS  PubMed  Google Scholar 

  49. Susac J: Susac’s syndrome. The triad of microangiopathy of the brain and retina with hearing loss in young women. Neurology 1994, 44:591–593.

    CAS  PubMed  Google Scholar 

  50. Moore PM: Diagnosis and management of isolated angiitis of the central nervous system. Neurology 1989, 39:167–173.

    CAS  PubMed  Google Scholar 

  51. Perret G, Nishioka H: Report on the cooperative study of intracranial aneurysms and subarachnoid hemorrhage. Section VI. Arteriovenous malformations. J Neurosurg 1966, 25:467–490.

    Article  CAS  PubMed  Google Scholar 

  52. DeGirolami V, Haas ML, Richardson EP Jr: Subacute diencephalic angioencephalopathy: a clinicopathological case study. J Neurol Sci 1974, 22:197–210.

    Article  CAS  PubMed  Google Scholar 

  53. Gorelick PB, Erkinjuntti T, Hofman A, et al.: Prevention of vascular dementia. Alzheimer Dis Assoc Disord 1999, 13(Suppl 3):S131–S139.

    Article  PubMed  Google Scholar 

  54. Jick H, Zornberg GL, Jick SS, et al.: Statins and the risk of dementia. Lancet 2000, 356:1627–1631.

    Article  CAS  PubMed  Google Scholar 

  55. Erkinjuntti T, Kurz A, Gauthier S, et al.: Efficacy of galantamine in probable vascular dementia and Alzheimer’s disease combined with cerebrovascular disease: a randomised trial. Lancet 2002, 359:1283–1290.

    Article  PubMed  Google Scholar 

  56. Black S, Roman GC, Geldmacher DS, et al.: Efficacy and tolerability of donepezil in vascular dementia: positive results of a 24-week, multicenter, international, randomized, placebo-controlled clinical trial. Stroke 2003, 34:2323–2330.

    Article  CAS  PubMed  Google Scholar 

  57. Wilkinson D, Doody R, Helme R, et al.: Donepezil in vascular dementia: a randomized, placebo-controlled study. Neurology 2003, 61:479–486.

    CAS  PubMed  Google Scholar 

  58. Aguilar M, Roman G, Black S, et al.: Efficacy and safety of donepezil in vascular dementia: results from the largest double-blind trial in vascular dementia [abstract P4-439]. Presented at the 10th International Conference on Alzheimer’s Disease and Related Disorders. Madrid, Spain; July 15–20, 2006.

  59. Kavirajan H, Schneider LS: Efficacy and adverse effects of cholinesterase inhibitors and memantine in vascular dementia: a meta-analysis of randomized clinical trials. Lancet Neurol 2007, 6:782–792.

    Article  CAS  PubMed  Google Scholar 

  60. Dichgans M, Markus HS, Salloway S, et al.: Donepezil in patients with subcortical vascular cognitive impairment: a randomized double-blind trial in CADASIL. Lancet Neurol 2008, 7:310–318.

    Article  CAS  PubMed  Google Scholar 

  61. Wilcock G, Mobius HJ, Stoffler A; MMM 500 Group: A double-blind, placebo-controlled multicentre study of memantine in mild to moderate vascular dementia (MMM 500). Int Clin Psychopharmacol 2002, 17:297–305.

    Article  CAS  PubMed  Google Scholar 

  62. Orgogozo JM, Rigaud AS, Stoffler A, et al.: Efficacy and safety of memantine in patients with mild to moderate vascular dementia: a randomized, placebo-controlled trial (MMM 300). Stroke 2002, 33:1834–1839.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, Vanderbilt University Medical Center, A-0118 Vanderbilt Medical Center North, Nashville, TN, 37232, USA

    Howard S. Kirshner

Authors
  1. Howard S. Kirshner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Howard S. Kirshner.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kirshner, H.S. Vascular dementia: A review of recent evidence for prevention and treatment. Curr Neurol Neurosci Rep 9, 437–442 (2009). https://doi.org/10.1007/s11910-009-0065-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11910-009-0065-y

Keywords

Search

Navigation