The prevalence of cerebro-vascular disease in patients with Alzheimer disease varies widely among studies depending on being autopsy-based or clinical-pathology or neuro-image based.

AD+CVD patients may show some degree of variability on the diagnoses and therapeutic approach across different clinical specialists.

To observe potential differences among physicians on the diagnosis and therapeutic approach of patients with AD+CVD.

This was a cross-sectional, multi-center, nation-wide study performed in Spain.

The investigators participants worked in three clinical specialties: neurologists, geriatricians and psychiatrists.

A total of 107 investigators were involved in this study. Three out of four doctors (76%) were neurologists (81), 14% were geriatricians (15), and 8.4% were psychiatrists (9). The investigators included 720 patients diagnosed with AD+CVD.

Neuro-image techniques (NIT) and medical history (MH) were the most common methods of diagnosis. The scanner was performed in 69% AD+CVD patients, and magnetic resonance image was performed in 45%.

There were significant differences among physicians on the frequency of use of MH (98% of neurologists/geriatricians used MH vs. 85% of psychiatrists (p<0,04)), and also on the use of NIT (99% of neurologists/geriatricians vs. 84% of psychiatrists (p<0,0001)).

Galantamine (60%) and memantine+donepezil (19%)were the most common prescribed drugs by psychiatrists.

Psychiatrists used primarily MH to diagnose patients with AD+CVD, while neurologists used more frequently NIT. Geriatricians used both methods and vascular risk factors for the diagnosis of AD+CVD.

More than a half of physicians used galantamine as first-election treatment in patients with AD+CVD.