Vascular dementia (VD) is the second most common form of dementia after Alzheimer disease. It is not a single disease but a group of syndromes of cognitive impairment caused by different mechanisms causing ischaemia or haemorrhage secondary to cerebrovascular disease. Vascular dementia has been increasingly recognised as the most severe form of the spectrum of deficits encompassed by the term vascular cognitive impairment (VCI). Early detection and an accurate diagnosis are important in the prevention of vascular dementia.

Epidemiology

• VD is thought to account for around 17% of dementia in the UK
• Prevalence of dementia following a first stroke varies depending on location and size of the infarct, definition of dementia, interval after stroke and age among other variables. Overall, stroke doubles the risk of developing dementia.
• Incidence increases with age

The main subtypes of VD:

• Stroke-related VD - multi-infarct or single-infarct dementia
• Subcortical VD - caused by small vessel disease
• Mixed dementia - the presence of both VD and Alzheimer's disease

Risk factors

• History of stroke or transient ischaemic attack (TIA)
• Atrial fibrillation
• Hypertension
• Diabetes mellitus
• Hyperlipidaemia
• Smoking
• Obesity
• Coronary heart disease
• A family history of stroke or cardiovascular

Rarely, VD can be inherited as in the case of CADASIL (cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy.