Materiały źródłowe

• #1 Vascular Dementia: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/22216-vascular-dementia

  Vascular dementia is a common type of dementia that happens when theres decreased blood flow to areas of your brain. […] Healthcare providers may use the term vascular cognitive impairment (VCI) instead of vascular dementia. […] Confirming a diagnosis of vascular dementia needs evaluation by a specialist. […] Your healthcare provider will: Ask about the course of your symptoms. […] Theyll then likely recommend a variety of tests, including laboratory, imaging and neurocognitive tests. […] Healthcare providers use the following criteria to diagnose vascular dementia: Neurocognitive testing confirms the diagnosis of dementia or MCI. […] Theres brain imaging evidence (usually with MRI) confirming a recent stroke or other vascular brain changes that are consistent with the types of cognitive impairment you have.

• #1 Diagnosing vascular dementia | Alzheimer’s Society

  https://www.alzheimers.org.uk/about-dementia/types-dementia/diagnosis-vascular-dementia

  A diagnosis of vascular dementia usually starts with a conversation with a GP. There is no single test for vascular dementia, and a diagnosis may be based on a combination of things. […] Getting an early diagnosis of vascular dementia has many benefits. It means other conditions can be ruled out and it gives the person an explanation for their symptoms. […] A diagnosis also gives a person access to treatment, advice and support, and allows them to prepare for the future and plan ahead. […] The GP will often make an initial assessment and then refer the person to a local memory service for a more detailed assessment. Here, specialist health professionals will have lots of combined expertise in dementia and can arrange more detailed tests and brain scans, if needed. […] Sometimes a GP will make the diagnosis if it is very clear that the person has dementia. In this case, they will not need to be referred to a specialist.

• #1 Diagnosing vascular dementia | Alzheimer’s Society

  https://www.alzheimers.org.uk/about-dementia/types-dementia/diagnosis-vascular-dementia

  A person with dementia should receive a clear explanation of their diagnosis, if they want to know it. It should be explained in a way that they can understand. There should also be a discussion about the next steps and what support is available. […] A diagnosis is based on a combination of things, including: taking a history the health professional talks to the person, and ideally someone who knows them well, about their problems and how they are affecting the persons daily life […] physical examination and tests (for example, blood tests) to rule out other possible causes of the persons symptoms […] mental ability tests (for example, memory and thinking) these are generally carried out by a nurse, occupational therapist or doctor, although sometimes more specialist tests may be done by a neuropsychologist.

• #1

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5619038/

  Recommendations – A diagnosis of VaD must be based on specific criteria, with NINDS-AIREN being the most frequently used in research settings (Level A). […] Anamnesis is fundamental and must include questions on all aspects related to a dementia condition of vascular cause, such as mode of onset, pattern of progression, prior history (CVA, revascularization), comorbidities (SAH, DL, DM, anemia, sleep and psychiatric disorders), habits (eating, life-style, tobacco and alcohol use), familial and educational history. […] Recommendations – Anamnesis is fundamental and data must be supplemented by a companion that is as well informed as possible (Level A). […] Supplementary exams play a key role in the diagnostic process of VaD (and of vascular CIND). […] Neuroimaging plays a pivotal role in the diagnostic process of patients with suspected dementia or that present with VaD (and vascular CIND), providing not only structural but also functional information.

• #1 Vascular dementia – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/319

  Vascular dementia is characterised by a chronic progressive multifaceted impairment of cognitive function. […] Vascular dementia is the second most common cause of dementia in older people after Alzheimers disease. […] Early aggressive treatment of vascular risk factors is suggested in order to prevent further cerebrovascular disease. […] Vascular dementia is a chronic progressive disease of the brain bringing about cognitive impairment. […] The executive functions of the brain such as planning are more prominently affected than memory. […] Key diagnostic factors include history of stroke(s), difficulty solving problems, apathy, disinhibition, slowed processing of information, poor attention, retrieval memory deficit, frontal release reflexes, focal neurological signs, and impaired gait and balance. […] 1st investigations to order include FBC, erythrocyte sedimentation rate, blood glucose level, renal and liver function tests, vitamin B12, folate, thyroid function, MRI brain, ECG, and neuropsychological testing.

• #1 Vascular Dementia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430817/

  Vascular dementia is among the most common etiologies of major neurocognitive disorder (MND), affecting primarily older adults (65), and it is the leading nondegenerative cause of dementia. […] Diagnosis relies upon a thorough history and physical/neurologic (including mental status) examination. Neuroimaging increases the precision of the diagnosis. Treatment is supportive in the ongoing absence of disease-modifying medications for vascular dementia approved by regulatory bodies. […] Diagnosis of vascular dementia requires a thorough history and physical/neurologic examination, including mental status. […] The initial evaluation of a patient with possible cognitive impairment of vascular origin must include a formal cognitive assessment. […] The standard workup for vascular dementia includes neuroimaging, laboratory assessment, and, if at all possible, neuropsychological testing.

• #1 Vascular Dementia: Diagnosis and Management

  https://biomedgrid.com/fulltext/volume24/vascular-dementia-diagnosis-and-management.003249.php

  Newer DSM criteria and AHA/ASA seem to be more able to discriminate mixed dementia from probable vascular dementia and therefore can be useful in clinical practice to aid treatment planning and conversations with patients about prognosis. […] Imaging is key in accurate diagnosis and usually requires access to MRI scanning. […] Typically the natural history of the disease is one of a step like progression with sudden onset drops in level of cognitive ability linked to stroke episodes which are separated from each other in time. […] The most commonly used cognitive assessments in clinical practice are still Mini Mental State Examination (MMSE) or the Montreal Cognitive Assessment (MOCA). […] Differentiating affected cognitive domains does not add diagnostic value. […] Making a diagnosis and managing a patient with cognitive impairment involves an evaluation of their vascular risk. Risk factors for vascular dementia are either modifiable or non modifiable and overlap with those for cardiovascular disease.

• #1 Vascular dementia – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/vascular-dementia/diagnosis-treatment/drc-20378798

  MRIs are generally the preferred imaging test because MRIs can provide even more detail than computed tomography (CT) scans about strokes, ministrokes and blood vessel abnormalities and is the test of choice for evaluating vascular dementia. […] Neuropsychological tests sometimes show characteristic results for people with different types of dementia. People with vascular dementia may have an exceptionally hard time analyzing a problem and developing an effective solution. […] While much focus is placed on distinguishing Alzheimer’s dementia from vascular dementia, it turns out there is usually substantial overlap. Most people diagnosed with Alzheimer’s dementia have a vascular component and similarly most people with vascular dementia have some degree of coexisting Alzheimer’s changes in their brain.

• #1

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5619038/

  Structural neuroimaging must be performed as routine and a number of diagnostic criteria for VaD expressly require neuroimaging as a core item, such as the NINDS-AIREN, in which the technique is essential for diagnosing probable VaD. […] Recommendations – Structural neuroimaging should be used in all patients with suspected dementia, preferably using MRI (Level A). […] The blood test is a necessary part of the assessment in cases of cognitive disorder so as to identify comorbidities and/or complications; reveal potential risk factors; explore causes of frequently associated confusional states, and less often, identify the primary cause of the dementia. […] Recommendations – Blood tests should be performed at first assessment, including routine items and those representing a potential cause of cognitive impairment or as comorbidity, including exams which represent VRFs (Level A).

• #1 Tests for diagnosing dementia – NHS

  https://www.nhs.uk/conditions/dementia/symptoms-and-diagnosis/tests/

  There’s no single test for dementia. A diagnosis is based on a combination of assessments and tests. These may be done by a GP or a specialist at a memory clinic or hospital. […] People with symptoms of dementia are given tests to check their mental abilities, such as memory or thinking. […] These tests are known as cognitive assessments, and may be done initially by a GP. […] Although these tests cannot diagnose dementia, they may show there are memory difficulties that need further investigation. […] Your GP will arrange for blood tests to help exclude other causes of symptoms that can be confused with dementia. […] Brain scans are often used for diagnosing dementia once the simpler tests have ruled out other problems. […] Like memory tests, on their own brain scans cannot diagnose dementia, but are used as part of the wider assessment. […] An MRI scan is recommended to help confirm a diagnosis of dementia and the type of disease causing the dementia. […] provide detailed information about the blood vessel damage that happens in vascular dementia.

• #1 Vascular dementia – Wikipedia

  https://en.wikipedia.org/wiki/Vascular_dementia

  When available as a diagnostic tool, single photon emission computed tomography (SPECT) and positron emission tomography (PET) neuroimaging may be used to confirm a diagnosis of multi-infarct dementia in conjunction with evaluations involving mental status examination. […] In a person already having dementia, SPECT appears to be superior in differentiating multi-infarct dementia from Alzheimer’s disease, compared to the usual mental testing and medical history analysis. […] Differentiating dementia syndromes can be challenging, due to the frequently overlapping clinical features and related underlying pathology. Mixed dementia, involving two types of dementia, can occur. In particular, Alzheimer’s disease often co-occurs with vascular dementia. […] Mixed dementia is diagnosed when people have evidence of Alzheimer’s disease and cerebrovascular disease, either clinically or based on neuro-imaging evidence of ischemic lesions.

• #1 Vascular dementia – symptoms, treatments and causes | healthdirect

  https://www.healthdirect.gov.au/vascular-dementia

  Vascular dementia is a form of dementia that develops because of problems with the blood supply to your brain. […] How is vascular dementia diagnosed? […] Your doctor will ask you about your symptoms and general health. It’s a good idea to take a family member or carer with you to help give a good description of your symptoms. […] There is no single test for vascular dementia. It can be difficult to distinguish from other types of dementia. Your doctor will likely refer you to a specialist doctor this may be a neurologist or a geriatrician. […] Tests that may be recommended are: blood tests, brain imaging tests, such as a CT scan or MRI scan to show any evidence of strokes, an ultrasound scan to look for any problems in your carotid arteries (which run up both sides of your neck to your brain), neuropsychological testing to measure your brain function, an electrocardiogram (ECG) to check your heart rhythm.

• #1 Vascular dementia | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/vascular-dementia?lang=us

  Vascular dementia, also known as vascular cognitive impairment, is the second most common cause of dementia after the far more common Alzheimer disease. It is primarily seen in patients with atherosclerosis and chronic hypertension and results from the accumulation of multiple white matter lesions or cortical infarcts, although cerebral hemorrhages can be variably included. […] Generally, cortical dementia and strategic infarct dementia, usually due to large vessel occlusion, have a definable time of onset and specific deficits related to the region affected. […] Some authors have suggested that leukoaraiosis should involve at least 25% of the white matter in order to qualify for vascular dementia on imaging. […] Both CT and MRI are able to provide evidence of ischemic damage, however, MRI is more sensitive, especially to white matter small vessel ischemic change as well as to microhemorrhages seen in cerebral amyloid angiopathy and chronic hypertensive encephalopathy.

• #1 Vascular Dementia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430817/

  Laboratory assessment should include basic labs, such as a complete blood count and a comprehensive metabolic panel. […] Neuroimaging is essential for making rigorous diagnoses of MND. MRI is the preferred imaging modality because its different sequences and orientations provide essential insights in evaluating cognitive impairment. […] Neuropsychological testing is invaluable for fleshing out the full scope of cognitive and behavioral changes in all cases of MND, including vascular dementia. […] The main differential diagnosis for vascular dementia is Alzheimer Disease and mixed dementia presentations are quite common. […] Diagnosis of vascular dementia allows physicians to provide patients and caregivers with valuable counseling about secondary prevention, safety, advance care planning, and caregiver burden.

• #1 Vascular Dementia Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/292105-workup

  Laboratory tests should be performed to rule out other causes of dementia. These tests should routinely include a CBC count, erythrocyte sedimentation rate, glucose level, renal and liver function tests, serologic tests for syphilis, vitamin B-12 and red blood cell folate levels, and thyroid function tests. […] Neuroimaging studies may include CT brain scanning and MRI of the brain. The absence of cerebrovascular lesions on CT scanning or MRI is evidence against vascular etiology. The features on CT scanning or MRI that are suggestive of vascular dementia are bilateral multiple infarcts located in the dominant hemisphere and limbic structures, multiple lacunar strokes, or periventricular white matter lesions extending into the deep white matter. […] Functional imaging may also be used for diagnosis. According to a 2000 study by Nagata et al, positron emission tomography may be useful for differentiating vascular dementia from AD. Hypoperfusion and hypometabolism can be observed in the frontal lobe, including the cingulate and superior frontal gyri, in patients with vascular dementia; a parietotemporal pattern is observed in patients with AD. […] Cerebral angiography is not performed routinely during the evaluation of vascular dementia, but it is performed before carotid artery surgery. It also is useful in cases of possible cerebral vasculitis; cerebral vessels can demonstrate beading.

• #1 Dementia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dementia/diagnosis-treatment/drc-20352019

  To diagnose the cause of dementia, a health care professional must recognize the pattern of loss of skills and function. […] No single test can diagnose dementia. You’ll likely need a number of tests that can help pinpoint the problem. […] A health care professional reviews your medical history and symptoms and conducts a physical exam. […] These tests evaluate your thinking ability. […] Your memory, language skills, visual perception, attention, problem-solving skills, movement, senses, balance, reflexes and other areas are evaluated. […] These scans can check for evidence of stroke, bleeding, tumor or fluid buildup, known as hydrocephalus. […] Simple blood tests can detect physical problems that can affect brain function, such as too little vitamin B-12 in the body or an underactive thyroid gland.

• #1

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5619038/

  The cerebrospinal fluid exam (CSF) has an important place in diagnosing neurodegenerative dementia (AD, FTD, DLB, CJD) through the study of markers based on -amyloid peptide (A) and total tau and phospho-tau protein. […] Recommendations – The CSF exam is recommended in certain situations (inflammatory diseases, vasculitis, rapidly progressive dementia) (Good Practice Point).

• #1 Researchers identify biomarker for diagnosing vascular dementia | UCLA Health

  https://www.uclahealth.org/news/release/researchers-identify-biomarker-diagnosing-vascular-dementia

  Measuring a key blood molecule may help doctors diagnose whether or how much impaired blood flow to a patients brain is contributing to dementia or cognitive problems, according to a new study led by a UCLA Health researcher. […] However, it can be difficult for doctors to determine whether a patients cognitive impairments stem predominately from Alzheimers disease or vascular problems, the two most common causes of dementia. […] In new research published Feb. 23 in Alzheimer’s Dementia: The Journal of the Alzheimer’s Association, researchers found that patients with higher levels of placental growth factor (PlGF) a key molecule involved in the formation of new blood vessels, or angiogenesis were more likely to have cognitive impairment or evidence of brain injury. […] It may also tell us who might be the best candidates for some of the really new emerging drugs that are available on the market to treat cognitive impairment and dementia.

• #1 Researchers identify biomarker for diagnosing vascular dementia | UCLA Health

  https://www.uclahealth.org/news/release/researchers-identify-biomarker-diagnosing-vascular-dementia

  The study represents some of the first validation results reported by a NIH-funded consortium of academic medical centers working to identify biomarkers associated with vascular drivers behind cognitive impairment to help inform diagnosis and treatment. […] Data also gathered by the consortium had suggested this may be a useful biomarker for identifying patients with cognitive impairment and dementia due to vascular brain injury. […] Researchers found those in the top quartile for PlGF measurement were three times as likely to have cognitive impairment or dementia compared to those in the bottom quartile. […] The addition of a blood-based biomarker that is associated with the traditional measures of vascular injury could allow a provider to be able to distinguish the patient that has Alzheimer’s-predominant dementia versus a significant vascular contribution, Dr. Hinman said. […] This work can directly inform this diagnostic decision.

• #1 Vascular Dementia Clinical Presentation: History, Physical, Causes

  https://emedicine.medscape.com/article/292105-clinical

  DSM-5-TR categorizes vascular dementia as an etiological subtype of either major or mild neurocognitive disorder. […] Probable vascular neurocognitive disorder is diagnosed if one of the following is present: Clinical criteria are supported by neuroimaging evidence of significant parenchymal injury attributed to cerebrovascular disease; the neurocognitive syndrome is temporarily related to one or more documented cerebrovascular events; both clinical and genetic evidence of cerebrovascular disease is present. […] The NINDS-AIREN criteria are the most specific of all available criteria and are used most commonly in research. […] Patients with vascular dementia have patchy neuropsychological deficits. […] Some cognitive patterns may help to differentiate vascular dementia clinically from AD. […] Neuropsychological findings vary with the site and severity of cerebrovascular disease. […] Behavioral problems assessment: Behavioral disturbances are common in dementia and are associated with adverse outcomes, increased disability, caregiver stress, and earlier institutionalization.

• #1 Vascular Dementia – PsychDB

  https://www.psychdb.com/geri/dementia/vascular

  Possible vascular neurocognitive disorder is diagnosed if the clinical criteria are met but neuroimaging is not available and the temporal relationship of the neurocognitive syndrome with one or more cerebrovascular events is not established. […] The criteria for the clinical diagnosis of probable vascular dementia include all of the following: Dementia defined by cognitive decline from a previously higher level of functioning and manifested by impairment of memory and of two or more cognitive domains. […] Cerebrovascular disease, defined by the presence of focal signs on neurologic examination, such as hemiparesis, lower facial weakness, Babinski sign, sensory deficit, hemianopia, and dysarthria consistent with stroke. […] A relationship between the above two disorders, manifested or inferred by the presence of one or more of the following: (a) onset of dementia within 3 months following a recognized stroke; (b) abrupt deterioration in cognitive functions; or fluctuating, stepwise progression of cognitive deficits.

• #1 Differential Diagnosis of Vascular Dementia | alz.org

  https://www.alz.org/professionals/health-systems-medical-professionals/dementia-diagnosis/differential-diagnosis/differential-diagnosis-of-vascular-dementia

  About 5% to 10% of people with dementia have vascular dementia alone. It is more common as a part of mixed dementia. […] Traditionally, uniform diagnostic criteria for vascular dementia have been lacking. The clearest clinical picture may be impairment in one or more cognitive domains within a few months after a stroke, sometimes termed post-stroke dementia. […] The Hachinski Ischemic Scale is a tool widely used to identify a likely vascular component once a dementia diagnosis has been established. A shortened 7-item version of the HIS has been validated. A score 2 suggests vascular involvement. […] Because vascular dementia is closely tied to diseases of the heart and blood vessels, many experts consider it the most potentially treatable form. Monitoring of blood pressure, weight, blood sugar and cholesterol should begin early in life. Active management of these risk factors, avoidance of smoking and excess alcohol and treatment of underlying heart and blood vessel diseases could play major roles in preventing later cognitive decline for many individuals. […] Once vascular dementia develops, no drugs are approved by the FDA to treat it.

• #1 Diagnosis of vascular cognitive impairment and its main categories | Neurología (English Edition)

  https://www.elsevier.es/en-revista-neurologia-english-edition–495-articulo-diagnosis-vascular-cognitive-impairment-its-S2173580815000425

  The DSM-IV criteria list loss of executive function as a secondary feature for diagnosis of dementia, but some researchers consider it to be essential. […] Stipulating that more than one cognitive domain must be impaired distinguishes dementia from single-dominion deficits due to stroke, amnesia, or Korsakoff syndrome. […] One of the main obstacles to standardising diagnostic criteria for vascular dementia has to do with the ambiguous, heterogeneous, and overlapping features referred to in definitions of cerebrovascular lesions and vascular disorders. […] The classic types or categories that have been proposed for ischaemic vascular dementia (multi-infarct dementia, subcortical vascular dementia, strategic-infarct dementia) overlap in various ways due to the lack of clear distinguishing features, which once again reflects the heterogeneous nature of vascular dementia.

• #1 When Is It Vascular Dementia? | Kettering Health

  https://ketteringhealth.org/when-is-it-vascular-dementia/

  Dr. Patel says vascular dementia is a “diagnosis of exclusion,” meaning that while looking at heart health and blood flow is critical to a diagnosis, other causes for dementia-like symptoms—Alzheimer’s, depression, thyroid conditions—need to be ruled out. […] If a PET scan doesn’t show plaque in the brain, pointing to Alzheimer’s, Dr. Patel says imaging of the heart and blood flow, called an angiogram, would follow. The goal, Dr. Patel clarifies, is to get as full a picture as possible and “assess if a patient fits the criteria for vascular dementia based on all available information.” […] If imaging shows reduced blood flow from a stroke, heart disease, or blockages, improving blood flow can help quite a bit. “This form of dementia is so connected to blood flow to the brain that after treatment, patients often report feeling like themselves again, with better energy, personality, and judgment. It’s remarkable.” […] Left untreated, the life expectancy for someone with advanced vascular dementia is around five years.

• #1 What Is Vascular Dementia?

  https://www.alzheimers.gov/alzheimers-dementias/vascular-dementia

  To diagnose vascular dementia, a doctor may ask about problems with daily activities, conduct memory or thinking tests, and speak with someone who knows the person well to see if symptoms of dementia are present. Medical history, lifestyle, and brain imaging tests are often used to help determine whether vascular dementia is the cause of symptoms. […] No treatments are available to reverse brain damage that has been caused by a stroke. Treatment for vascular dementia focuses on preventing future strokes. Medications to prevent strokes, such as blood thinners, may help decrease the risk of further damage to the brain. Medications that help treat the symptoms of Alzheimer’s disease might benefit people with early vascular dementia. A doctor may also recommend treating risk factors, such as high blood pressure or high cholesterol, through medications and lifestyle changes.

• #1 Vascular dementia: A diagnosis running out of time | The British Journal of Psychiatry | Cambridge Core

  https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/vascular-dementia-a-diagnosis-running-out-of-time/DCF85B59772070FC97AC9101D42D1781

  What is becoming increasingly apparent is that dementia associated with vascular disease frequently resembles Alzheimer’s disease in its clinical course and, in many cases, is not obviously explained by a multiple infarction mechanism. […] The usefulness of vascular dementia as a diagnostic category is questionable since it involves a high degree of subjective judgement, subsumes a large number of potentially heterogeneous conditions and overlaps considerably with Alzheimer’s disease. […] The current system of classifying dementia into mutually exclusive subtypes poorly reflects mixed disease in older age groups and has become an important issue since these diagnoses now determine eligibility for pharmacological intervention.

• #2 Facts on Vascular Dementia and How it Impacts the Cognitive Structure

  https://gamemorynet.org/pcp_news/facts-on-vascular-dementia-and-how-it-impacts-the-cognitive-structure/

  Vascular dementia is second only to Alzheimers as the most prevalent cause of dementia. […] Vascular Dementia can happen in conjunction with other conditions such as Alzheimers disease and Lewy Body Dementia. […] A growing number of experts are using the term Vascular Cognitive Impairment (VCI) instead of Vascular Dementia, as highlights the thinking changes that can range from mild to severe. […] We recommend screening for Vascular Dementia for high-risk categories of patients, including patients that have had a stroke or a transient ischemic attack (TIA or ministroke). […] The following are considered core elements of a workup for vascular dementia: A thorough medical history, including family history of dementia; Evaluation of independent function and daily activities; Input from a family member or trusted friend; In-office neurological examination assessing function of nerves and reflexes, movement, coordination, balance and senses; Laboratory tests including blood tests and brain imaging.

• #2 Vascular dementia – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/vascular-dementia/diagnosis-treatment/drc-20378798

  Doctors can nearly always determine that you have dementia, but there’s no specific test that confirms you have vascular dementia. Your doctor will make a judgment about whether vascular dementia is the most likely cause of your symptoms based on the information you provide, your medical history for stroke or disorders of the heart and blood vessels, and results of tests that may help clarify your diagnosis. […] Images of your brain can pinpoint visible abnormalities caused by strokes, blood vessel diseases, tumors or trauma that may cause changes in thinking and reasoning. A brain-imaging study can help your doctor zero in on more-likely causes for your symptoms and rule out other causes. […] Brain-imaging procedures your doctor may recommend to help diagnose vascular dementia include:

• #2 Vascular Dementia | Conditions | UCSF Health

  https://www.ucsfhealth.org/conditions/vascular-dementia

  A medical history and symptoms will be collected. Patients should be accompanied by a family member or friend who can provide information about the patient’s degree of memory loss and functional impairment with respect to daily activities. […] An evaluation of memory and ability to understand, communicate and other cognitive functions will be conducted. A patient will also be asked about depression and emotional behavior changes, since these are often altered in VaD. […] Patients will have a thorough physical exam to check for vascular disease, risk factors and other medical conditions, such as high blood pressure.

• #2 Vascular Dementia Clinical Presentation: History, Physical, Causes

  https://emedicine.medscape.com/article/292105-clinical

  Cognitive impairment, acutely or subacutely, after an acute neurologic event with a stepwise progression is a typical history suggestive of vascular dementia. […] Health professionals can perform a Mini-Mental Status Exam (MMSE), depression assessment screen using DSM-5-TR criteria, the Geriatric Depression Scale (GDS), or the Cornell Scale for depression in dementia. […] Major depression is a widely observed mood disorder in vascular dementia. […] Several specific diagnostic criteria can be used to diagnose vascular dementia, including the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR) criteria, the International Classification of Diseases, Eleventh Edition criteria, the National Institute of Neurological Disorders and Stroke-Association International pour la Recherch at L’Enseignement en Neurosciences (NINDS-AIREN) criteria, the Alzheimer’s Disease Diagnostic and Treatment Center criteria, and the Hachinski ischemic score.

• #2 Dementia – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/dementia/diagnosis-treatment/drc-20352019

  To diagnose the cause of dementia, a health care professional must recognize the pattern of loss of skills and function. […] No single test can diagnose dementia. You’ll likely need a number of tests that can help pinpoint the problem. […] A health care professional reviews your medical history and symptoms and conducts a physical exam. […] These tests evaluate your thinking ability. […] Your memory, language skills, visual perception, attention, problem-solving skills, movement, senses, balance, reflexes and other areas are evaluated. […] These scans can check for evidence of stroke, bleeding, tumor or fluid buildup, known as hydrocephalus. […] Simple blood tests can detect physical problems that can affect brain function, such as too little vitamin B-12 in the body or an underactive thyroid gland.

• #2 Vascular Dementia, Diagnosis, Treatment, clinical department / cdc

  https://www.linkedin.com/pulse/vascular-dementia-diagnosis-treatment-clinical-department-rs-nd

  Doctors can nearly always determine that you have dementia, but there’s no specific test that confirms you have vascular dementia. Your doctor will make a judgment about whether vascular dementia is the most likely cause of your symptoms based on the information you provide, your medical history for stroke or disorders of the heart and blood vessels, and the results of tests that may help clarify your diagnosis. […] Brain-imaging procedures your doctor may recommend to help diagnose vascular dementia include: […] MRIs are generally the preferred imaging test because MRIs can provide even more detail than CT scans about strokes, ministrokes, and blood vessel abnormalities and is the test of choice for evaluating vascular dementia. […] Neuropsychological tests sometimes show characteristic results for people with different types of dementia. People with vascular dementia may have an exceptionally hard time analyzing a problem and developing an effective solution.

• #2

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5619038/

  Structural neuroimaging must be performed as routine and a number of diagnostic criteria for VaD expressly require neuroimaging as a core item, such as the NINDS-AIREN, in which the technique is essential for diagnosing probable VaD. […] Recommendations – Structural neuroimaging should be used in all patients with suspected dementia, preferably using MRI (Level A). […] The blood test is a necessary part of the assessment in cases of cognitive disorder so as to identify comorbidities and/or complications; reveal potential risk factors; explore causes of frequently associated confusional states, and less often, identify the primary cause of the dementia. […] Recommendations – Blood tests should be performed at first assessment, including routine items and those representing a potential cause of cognitive impairment or as comorbidity, including exams which represent VRFs (Level A).

• #2 Etiology, clinical manifestations, and diagnosis of vascular dementia – UpToDate

  https://www.uptodate.com/contents/etiology-clinical-manifestations-and-diagnosis-of-vascular-dementia

  Etiology, clinical manifestations, and diagnosis of vascular dementia […] Vascular cognitive impairment and dementia (VCID) refers to those syndromes that are felt to be caused in whole or in part by cerebrovascular disease or impaired cerebral blood flow. The clinical syndrome of VCID encompasses all cognitive disorders, including vascular dementia as well as milder forms such as vascular mild cognitive impairment (MCI). Vascular dementia is the second most common form of dementia, only exceeded by Alzheimer disease (AD) in terms of prevalence and incidence. […] Neuroimaging has improved the ability to detect and diagnose stroke and silent manifestations of cerebrovascular disease that impair cognition. However, neuroimaging can also detect cerebrovascular brain injury in asymptomatic older adults; therefore, the mere presence of any cerebrovascular brain injury is not sufficient to diagnose vascular dementia. Clinical features and the location and severity of cerebrovascular brain injury detected on brain imaging must be used to make a clinical judgment whether cerebrovascular disease is sufficient to cause vascular dementia. As with the later-life neurodegenerative diseases such as AD, vascular neuropathology becomes very common with advanced aging and is usually accompanied by other neuropathologies, creating a diagnostic challenge.

• #2 All you need to know about brain scans and dementia – Alzheimer’s Research UK

  https://www.alzheimersresearchuk.org/news/all-you-need-to-know-about-brain-scans-and-dementia/

  When someone goes to the doctor with dementia symptoms, a brain scan can be used alongside other tests like blood tests and memory tests to find out the cause. Scans are not always used but can help a doctor to see what type of dementia someone has, and to rule out other conditions. […] Dementia is caused by different diseases, like Alzheimer’s disease and vascular dementia. These diseases damage different areas of the brain and cause different symptoms. Brain imaging allows doctors to see where damage has occurred. […] Brain scanning and imaging has led to more accurate ways to diagnose dementia. […] A CT scan involves combining a series of X-rays taken from different angles of the head to produce images of a person’s brain. CT scans are the most common type of brain scan used in dementia diagnosis.

• #2 All you need to know about brain scans and dementia – Alzheimer’s Research UK

  https://www.alzheimersresearchuk.org/news/all-you-need-to-know-about-brain-scans-and-dementia/

  PET scans detect specific molecules in the brain. They are more commonly used in research than for diagnosis. […] Different methods of imaging the brain have allowed doctors and researchers to understand more about the diseases that cause dementia. […] There is no single test for vascular dementia and the diagnosis will be made using a combination of tests such as a scan, memory tests and blood tests along with assessment of the person’s symptoms and medical history. […] PET scans are not normally used in isolation to diagnose dementia. They are used in combination with other tests such as blood tests and memory tests to determine the cause of somebody’s symptoms. […] CT scans are helpful for looking at physical changes to the brain that occur in people with dementia. They should always be used alongside other tests, like memory and thinking tests, when diagnosing dementia. […] In cases where a doctor is uncertain whether someone has dementia, they may be referred for a PET or SPECT scans. These tests are more specific than MRI or CT scans.

• #2 Diagnosing vascular dementia | Alzheimer’s Society

  https://www.alzheimers.org.uk/about-dementia/types-dementia/diagnosis-vascular-dementia

  A person suspected of having vascular dementia will usually also have a brain scan. Brain scans cannot identify vascular dementia by themselves, but they can be used along with other information to help confirm the diagnosis. […] A CT or MRI scan may show evidence of a recent stroke or of other changes in the brain. They may help to rule out a tumour or build-up of fluid inside the brain, which can have symptoms similar to those of vascular dementia. Some brain scans can also help tell the difference between vascular dementia and other types of dementia.

• #2 Vascular Dementia Workup: Laboratory Studies, Imaging Studies, Other Tests

  https://emedicine.medscape.com/article/292105-workup

  Laboratory tests should be performed to rule out other causes of dementia. These tests should routinely include a CBC count, erythrocyte sedimentation rate, glucose level, renal and liver function tests, serologic tests for syphilis, vitamin B-12 and red blood cell folate levels, and thyroid function tests. […] Neuroimaging studies may include CT brain scanning and MRI of the brain. The absence of cerebrovascular lesions on CT scanning or MRI is evidence against vascular etiology. The features on CT scanning or MRI that are suggestive of vascular dementia are bilateral multiple infarcts located in the dominant hemisphere and limbic structures, multiple lacunar strokes, or periventricular white matter lesions extending into the deep white matter. […] Functional imaging may also be used for diagnosis. According to a 2000 study by Nagata et al, positron emission tomography may be useful for differentiating vascular dementia from AD. Hypoperfusion and hypometabolism can be observed in the frontal lobe, including the cingulate and superior frontal gyri, in patients with vascular dementia; a parietotemporal pattern is observed in patients with AD. […] Cerebral angiography is not performed routinely during the evaluation of vascular dementia, but it is performed before carotid artery surgery. It also is useful in cases of possible cerebral vasculitis; cerebral vessels can demonstrate beading.

• #2 Vascular dementia – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/319

  Vascular dementia is characterised by a chronic progressive multifaceted impairment of cognitive function. […] Vascular dementia is the second most common cause of dementia in older people after Alzheimers disease. […] Early aggressive treatment of vascular risk factors is suggested in order to prevent further cerebrovascular disease. […] Vascular dementia is a chronic progressive disease of the brain bringing about cognitive impairment. […] The executive functions of the brain such as planning are more prominently affected than memory. […] Key diagnostic factors include history of stroke(s), difficulty solving problems, apathy, disinhibition, slowed processing of information, poor attention, retrieval memory deficit, frontal release reflexes, focal neurological signs, and impaired gait and balance. […] 1st investigations to order include FBC, erythrocyte sedimentation rate, blood glucose level, renal and liver function tests, vitamin B12, folate, thyroid function, MRI brain, ECG, and neuropsychological testing.

• #2 Patient education: Dementia (including Alzheimer disease) (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/dementia-including-alzheimer-disease-beyond-the-basics

  Blood tests are usually done to find out if a chemical or hormonal imbalance or vitamin deficiency is contributing to the person’s difficulties. Brain scans (usually magnetic resonance imaging [MRI]) are often performed in people with dementia to look for other problems. Sometimes the MRI can also help health care providers identify the type of dementia, since different types can have characteristic brain changes. A lumbar puncture (also called a „spinal tap”) is less commonly done to help identify the type of dementia. A positron emission tomography (PET) scan (another form of brain scan) can show the abnormal protein deposits seen in some people who have Alzheimer disease. This test has been more commonly performed in research studies but may also be used to confirm Alzheimer disease before newer medications are prescribed.

• #2 Vascular dementia: Could a blood biomarker aid early diagnosis?

  https://www.medicalnewstoday.com/articles/blood-biomarker-may-enable-early-diagnosis-of-vascular-dementia

  According to a new study, a blood biomarker could help diagnose vascular dementia in its early stages. […] Currently, diagnosis relies on neuroimaging to identify the damage to the blood vessels. […] A new study has shown that increased levels of a biomarker in blood plasma could help identify vascular dementia in its early stages. […] This new discovery of placental growth factor-based biomarker has important diagnostic and prognostic significance for vascular cognitive impairment, he added. […] The addition of a blood-based biomarker that is associated with the traditional measures of vascular injury could allow a provider to be able to distinguish the patient that has Alzheimers-predominant dementia versus a significant vascular contribution. […] The biomarker is found by analysis of a simple blood sample.

• #2 Vascular dementia: Could a blood biomarker aid early diagnosis?

  https://www.medicalnewstoday.com/articles/blood-biomarker-may-enable-early-diagnosis-of-vascular-dementia

  It has the potential to be a rapid, cost-effective method of differentiating vascular dementia from other forms of dementia. […] Using PlGF might help identify specific patients who may benefit from many of the new emerging drugs for vascular dementia, added Dr. Iyer. […] This study provides evidence in support of placental growth factor as a biomarker for vascular cognitive impairment which could, in combination with other measures, potentially help inform diagnosis in the future.

• #2 Vascular Dementia – PsychDB

  https://www.psychdb.com/geri/dementia/vascular

  Vascular dementia is a neurodegenerative disorder (dementia) that occurs due to cerebrovascular disease and hypoperfusion. […] As such, there are also varied definitions and criteria for the diagnosis of vascular dementia. […] The criteria are met for major or mild neurocognitive disorder. […] The clinical features are consistent with a vascular etiology, as suggested by either of the following: Onset of the cognitive deficits is temporally related to one or more cerebrovascular events. […] There is evidence of the presence of cerebrovascular disease from history, physical examination, and/or neuroimaging considered sufficient to account for the neurocognitive deficits. […] The symptoms are not better explained by another brain disease or systemic disorder. […] Probable vascular neurocognitive disorder is diagnosed if one of the following is present; otherwise possible vascular neurocognitive disorder should be diagnosed: Clinical criteria are supported by neuroimaging evidence of significant parenchymal injury attributed to cerebrovascular disease (neuroimaging-supported).

• #2

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5619038/

  Vascular dementia (VaD) is the most prevalent form of secondary dementia and the second most common of all dementias. […] The goal of the working group involved in the module „Vascular Dementia: diagnostic criteria and supplementary exams” was to put forward basic guidelines based on evidence for diagnosing VaD. […] The diagnostic criteria for VaD include the official sets (CID-10-CDP and DSM-IV) as well as those devised specifically for research (CADDTC, NINDS-AIREN, NINDS-AIREN modified). […] Based on the diagnostic criteria, a general definition of VaD can be derived and, considering the variations presented, its simplified unification can be formulated as shown below. The basic characteristic of VaD is cognitive impairment of multiple domains, with compromise often being non-uniform.

• #2 Diagnosis of vascular cognitive impairment and its main categories | Neurología (English Edition)

  https://www.elsevier.es/en-revista-neurologia-english-edition–495-articulo-diagnosis-vascular-cognitive-impairment-its-S2173580815000425

  Diagnosis of vascular cognitive impairment and its main categories […] The criteria for the diagnosis of vascular cognitive impairment have evolved, but available criteria were designed basically for differentiating between vascular dementia and dementia due to Alzheimer disease, and for research purposes. […] Standardisation is required, by a multidisciplinary expert team, as regards nomenclature and criteria for the diagnosis of the full spectrum associated with vascular cognitive impairment and especially for vascular dementia and its categories. […] Diagnosis for a dementia syndrome is performed on a purely clinical basis, drawing specifically from the medical history and the neurocognitive examination. […] The classic Hachinski Ischaemic Score and the Rosen modification do not include a definition of the cognitive syndrome.

• #2 Vascular Dementia, Diagnosis, Treatment, clinical department / cdc

  https://www.linkedin.com/pulse/vascular-dementia-diagnosis-treatment-clinical-department-rs-nd

  While much focus is placed on distinguishing Alzheimer’s dementia from vascular dementia, it turns out there is usually substantial overlap. Most people diagnosed with Alzheimer’s dementia have a vascular component and similarly, most people with vascular dementia have some degree of coexisting Alzheimer’s changes in their brains.

• #2 Frontiers | Neuropsychological differential diagnosis of Alzheimer’s disease and vascular dementia: a systematic review with meta-regressions

  https://www.frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2023.1267434/full

  Introduction: Diagnostic classification systems and guidelines posit distinguishing patterns of impairment in Alzheimer’s (AD) and vascular dementia (VaD). In our study, we aim to identify which diagnostic instruments distinguish them. […] We identified 122 studies with 17,850 AD and 5,247 VaD patients. […] Our findings show inferior performance of AD in episodic memory and superior performance in working memory. […] The utility of cognitive, behavioral, psychiatric, and functional measures in differential diagnosis is limited and should be complemented by other information. […] We found the greatest difference in verbal memory, showing that sVaD patients outperform AD patients. […] Finally, we identify research areas and avenues, which could significantly improve the diagnostic value of cognitive measures.

• #2 Diagnosing vascular dementia | Alzheimer’s Society

  https://www.alzheimers.org.uk/about-dementia/types-dementia/diagnosis-vascular-dementia

  A diagnosis of vascular dementia usually starts with a conversation with a GP. There is no single test for vascular dementia, and a diagnosis may be based on a combination of things. […] Getting an early diagnosis of vascular dementia has many benefits. It means other conditions can be ruled out and it gives the person an explanation for their symptoms. […] A diagnosis also gives a person access to treatment, advice and support, and allows them to prepare for the future and plan ahead. […] The GP will often make an initial assessment and then refer the person to a local memory service for a more detailed assessment. Here, specialist health professionals will have lots of combined expertise in dementia and can arrange more detailed tests and brain scans, if needed. […] Sometimes a GP will make the diagnosis if it is very clear that the person has dementia. In this case, they will not need to be referred to a specialist.

• #2 Vascular Dementia – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430817/

  Laboratory assessment should include basic labs, such as a complete blood count and a comprehensive metabolic panel. […] Neuroimaging is essential for making rigorous diagnoses of MND. MRI is the preferred imaging modality because its different sequences and orientations provide essential insights in evaluating cognitive impairment. […] Neuropsychological testing is invaluable for fleshing out the full scope of cognitive and behavioral changes in all cases of MND, including vascular dementia. […] The main differential diagnosis for vascular dementia is Alzheimer Disease and mixed dementia presentations are quite common. […] Diagnosis of vascular dementia allows physicians to provide patients and caregivers with valuable counseling about secondary prevention, safety, advance care planning, and caregiver burden.

• #2 Vascular Dementia: Signs, Symptoms, and Treatment

  https://www.helpguide.org/aging/dementia/vascular-dementia

  Vascular dementia is the second most common form of dementia, accounting for up to 40 percent of dementia cases in older adults. It is caused by reduced blood flow to the brain, usually from a stroke or series of strokes. […] Receiving a vascular dementia diagnosis can be a frightening and stressful experience. But while there is currently no cure, there are many things you can do to manage your symptoms, prevent further strokes, and enjoy a full, rewarding life. […] While there is currently no cure for vascular dementia, the earlier any brain damage is caught, the better your chance of preventing dementia, or at least slowing down the progression of the disease. […] Your doctor may prescribe medications to lower blood pressure and prevent clots from forming, and may change or stop medications that can exacerbate symptoms of dementia, such sedatives, antihistamines, or strong painkillers.

• #3

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5619038/

  Recommendations – A diagnosis of VaD must be based on specific criteria, with NINDS-AIREN being the most frequently used in research settings (Level A). […] Anamnesis is fundamental and must include questions on all aspects related to a dementia condition of vascular cause, such as mode of onset, pattern of progression, prior history (CVA, revascularization), comorbidities (SAH, DL, DM, anemia, sleep and psychiatric disorders), habits (eating, life-style, tobacco and alcohol use), familial and educational history. […] Recommendations – Anamnesis is fundamental and data must be supplemented by a companion that is as well informed as possible (Level A). […] Supplementary exams play a key role in the diagnostic process of VaD (and of vascular CIND). […] Neuroimaging plays a pivotal role in the diagnostic process of patients with suspected dementia or that present with VaD (and vascular CIND), providing not only structural but also functional information.

• #3 How is Vascular Dementia Diagnosed?

  https://www.healthline.com/health/dementia/how-is-vascular-dementia-diagnosed

  Theres no specific test to confirm you have vascular dementia. Doctors often arrive at a diagnosis after considering your symptoms and observations from a neurological exam, lab tests, and brain imaging. […] Doctors may recommend several tests to confirm a vascular dementia diagnosis and rule out other conditions that may present with similar symptoms. […] While laboratory tests dont directly diagnose vascular dementia, they can help rule out other causes of cognitive decline. […] A neurological exam helps assess how well your brain and nervous system are functioning. This can guide doctors in identifying signs of vascular dementia. […] Brain imaging allows doctors to see the structure of your brain and identify changes that might be causing cognitive symptoms. […] Diagnosing vascular dementia involves a combination of lab tests, neurological exams, and brain imaging. Recognizing the symptoms early and talking with a healthcare professional can make a significant difference in managing the condition.

• #3 Diagnosing vascular dementia | Alzheimer’s Society

  https://www.alzheimers.org.uk/about-dementia/types-dementia/diagnosis-vascular-dementia

  A diagnosis of vascular dementia usually starts with a conversation with a GP. There is no single test for vascular dementia, and a diagnosis may be based on a combination of things. […] Getting an early diagnosis of vascular dementia has many benefits. It means other conditions can be ruled out and it gives the person an explanation for their symptoms. […] A diagnosis also gives a person access to treatment, advice and support, and allows them to prepare for the future and plan ahead. […] The GP will often make an initial assessment and then refer the person to a local memory service for a more detailed assessment. Here, specialist health professionals will have lots of combined expertise in dementia and can arrange more detailed tests and brain scans, if needed. […] Sometimes a GP will make the diagnosis if it is very clear that the person has dementia. In this case, they will not need to be referred to a specialist.

• #4 Vascular dementia diagnosis – Alzheimer’s Research UK

  https://www.alzheimersresearchuk.org/dementia-information/types-of-dementia/vascular-dementia/diagnosis/

  Diagnosing dementia is important. It means someone can get the right treatments, support and help with their condition. If you are worried about dementia symptoms, or someone else’s, you should talk to your doctor as soon as possible. […] How is vascular dementia diagnosed? […] When you go to the doctor with memory concerns or symptoms of dementia, the doctor will: Ask you about symptoms and how they are affecting you. Ask a relative or close friend if they have noticed any changes. Check your medical history. Give you a physical check-up, checking your blood pressure and balance. Run a blood test to rule out some other possible causes, like vitamin deficiencies and thyroid disorders. They may also ask you for a urine sample. Ask you to do some memory and thinking tests. […] If your doctor suspects dementia, you may be referred to a memory clinic or another specialist doctor. A memory clinic or specialist doctor may: Do another physical check-up and some more memory and thinking tests. Send you for other tests like a brain scan. Brain scans such as CT (computerised tomography) or MRI (magnetic resonance imaging) may be used to show the doctors any changes in blood vessels or signs of a stroke/s.

• #4 Diagnosing vascular dementia | Alzheimer’s Society

  https://www.alzheimers.org.uk/about-dementia/types-dementia/diagnosis-vascular-dementia

  A diagnosis of vascular dementia usually starts with a conversation with a GP. There is no single test for vascular dementia, and a diagnosis may be based on a combination of things. […] Getting an early diagnosis of vascular dementia has many benefits. It means other conditions can be ruled out and it gives the person an explanation for their symptoms. […] A diagnosis also gives a person access to treatment, advice and support, and allows them to prepare for the future and plan ahead. […] The GP will often make an initial assessment and then refer the person to a local memory service for a more detailed assessment. Here, specialist health professionals will have lots of combined expertise in dementia and can arrange more detailed tests and brain scans, if needed. […] Sometimes a GP will make the diagnosis if it is very clear that the person has dementia. In this case, they will not need to be referred to a specialist.

• #5 Vascular Dementia: Symptoms, Types, Diagnosis, and Treatment

  https://www.webmd.com/stroke/vascular-dementia

  Vascular dementia is the second most common cause of dementia in older people. […] It’s also difficult to diagnose, so it’s hard to know precisely how many people have vascular dementia. […] Your doctor will look at your medical and family history, ask about your symptoms and the medications you’re taking, and do a physical exam, mental status tests, lab tests, and a CT scan or MRI to diagnose you with dementia. These tests will also help confirm that you have vascular dementia and not some other type. […] Your doctor may diagnose you with vascular dementia if: The mental status or neurocognitive testing indicates you have vascular dementia or cognitive problems. The MRI or CT scan shows you’ve had a stroke recently. Other tests suggest that your symptoms are not from other causes or conditions.

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