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  • Print publication year: 2020
  • Online publication date: September 2020

Chapter 2 - Vascular Dementia

from Section 1 - Epidemiology and Types of Disorders


Over the course of the last hundred years our understanding of dementia has undergone considerable change. For much of that time ‘senility’ was seen as an almost inevitable concomitant of ageing and was usually attributed to atherosclerosis. In the post-war period, a concept of multi-infarct dementia emerged, but at the same time Alzheimer’s disease (AD) came to be seen not as a rare young-onset disorder but as the cause of most cases of dementia. Indeed, the concept of dementia itself was built around the impairments seen in AD, notably the impairment of memory. With greater understanding of dementia, particularly its pathological basis, it came to be realized that many different kinds of pathology can produce a dementia syndrome and that multiple types of pathology are the rule rather than the exception. This chapter aims to review our current understanding of how cerebrovascular disease contributes to cognitive impairment in order to assist those involved in the assessment and management of people with cognitive impairments to understand the strengths and limitations of our current concepts, and to inform diagnosis and management.

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