Immunity & Ageing

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Pathophysiology of vascular dementia

Francesco Iemolo3,4,1,2*, Giovanni Duro4, Claudia Rizzo5,6, Laura Castiglia5,6, Vladimir Hachinski1 and Calogero Caruso5,6

Author Affiliations

1 Department of Clinical Neurological Sciences University of Western Ontario, Ontario, Canada

2 Robarts Research Institute Stroke Prevention & Atherosclerosis Research Centre, London, England, UK

3 U.O. di Neurologia, Ospedale di Vittoria, ASL7-Ragusa and Clinica Neurologica Università di Catania, Catania, Italia

4 Istituto di Biomedicina ed Immunologia Molecolare-Consiglio Nazionale delle Ricerche (IBIM-CNR), Palermo, Italy

5 U.O. di Immunoematologia e Medicina Trasfusionale, AOUP "Paolo Giaccone", Palermo, Italy

6 Dipartimento di Biopatologia e Metodologie Biomediche, Università di Palermo, Palermo, Italy

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Immunity & Ageing 2009, 6:13 doi:10.1186/1742-4933-6-13

Published: 6 November 2009

Abstract

The concept of Vascular Dementia (VaD) has been recognized for over a century, but its definition and diagnostic criteria remain unclear.

Conventional definitions identify the patients too late, miss subjects with cognitive impairment short of dementia, and emphasize consequences rather than causes, the true bases for treatment and prevention. We should throw out current diagnostic categories and describe cognitive impairment clinically and according to commonly agreed instruments that document the demographic data in a standardized manner and undertake a systematic effort to identify the underlying aetiology in each case.

Increased effort should be targeted towards the concept of and criteria for Vascular Cognitive Impairment and Post-Stroke Dementia as well as for genetic factors involved, especially as these categories hold promise for early prevention and treatment.