Problems in Evaluation and Diagnosis of Vascular Dementia

Abstract

Vascular dementia has been ill-defined term due to multifactorial etiopathology. Ischemic, hemorrhagic or hypoxic lesions can all lead to dementia. The differential diagnosis of vascular dementia and Alzheimer's disease is difficult. Although several diagnostic tools such as neuroimaging are used in the differential diagnosis of these two diseases, the differential diagnostic dilemmas are still controversial. There may be an associated degenerative pathology in vascular dementia cases (mixed dementia). Some dementias occurring after cerebrovascular lesion have a progressive course suggesting a degenerative rather than a vascular origin. In the diagnosis and differential diagnosis of vascular dementia, detailed criteria for the diagnosis of vascular dementia have developed. But in general, these criteria have a good sensitivity but a low specificity. The use of these scales together with neuroimaging will offer the greatest accuracy in the diagnosis.