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Vascular dementia: The role of cerebral infarcts

Lookup NU author(s): Dr Timo Erkinjuntti, Professor Raj KalariaORCiD


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Although vascular dementia (VaD) is the second most frequent cause of dementia after Alzheimer disease (AD): the concept remains controversial in terms of delineation. The objective of this review is to investigate, from available literature, the role of cerebral infarcts in the pathogenesis of VaD and to identify areas of interest that need further evaluation and research. The incidence of new onset dementia is increased after stroke. Stroke subtypes, total volume of cerebral infarction and functional tissue loss, and location of the lesions are probably the major determinants of VaD. Any cause of stroke can lead to VaD. In some circumstances the causal relation between stroke and dementia is clear: (1) in young patients who are unlikely to have associated Alzheimer pathology; (2) when the cognitive functioning was normal before stroke, impaired immediately after, and does not worsen over time; (3) when the lesions are located in strategic areas; and (4) when a well-defined vasculopathy known to cause dementia is proven. However, several issues remain unsolved in VaD: lack of specificity of the diagnostic criteria; influence of white matter changes and associated Alzheimer pathology; influence of preexisting cognitive status; possibility of having VaD without stroke and the clinical relevance of silent infarcts to VaD; and best therapeutic strategy to be used to prevent VaD and to prevent stroke in patients with VaD. These questions form the basis for proposals for future research.

Publication metadata

Author(s): Kalaria RN; Erkinjuntti T; Leys D; Desmond DW; Schmidt R; Englund E; Pasquier F; Parnetti L; Ghika J; Chabriat H; Scheltens P; Bogousslavsky J

Publication type: Conference Proceedings (inc. Abstract)

Publication status: Published

Conference Name: 1st International Conference on Development of Drug Treatment for Vascular Dementia

Year of Conference: 1999

Pages: S38-S48

ISSN: 0893-0341

Publisher: Lippincott Williams & Wilkins


DOI: 10.1097/00002093-199912001-00007

Library holdings: Search Newcastle University Library for this item

Series Title: Alzheimer Disease and Associated Disorders

ISBN: 15464156