Vascular dementia
Vascular cognitive impairment by VICCCS, its subtypes (post-stroke, subcortical small vessel, multi-infarct, mixed), the imaging that supports it, CADASIL and cerebral amyloid angiopathy, and why vascular risk control rather than cholinesterase inhibitors is the main treatment.
Tier 1Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Cognitive impairment caused by cerebrovascular disease. Pure vascular dementia is about 15 to 20% of dementia; mixed vascular and Alzheimer pathology is the commonest finding in people over 80.
- Vascular cognitive impairment (VCI) spans mild VCI to major VCI (vascular dementia).
- Classic picture: slowed thinking, executive dysfunction, apathy, gait disturbance and urinary urgency, with a stepwise course after strokes or a gradual one from small vessel disease.
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Sources
- Progress toward standardized diagnosis of vascular cognitive impairment: guidelines from the Vascular Impairment of Cognition Classification Consensus Study (Skrobot OA et al. Alzheimers Dement 2018;14:280-92)Alzheimer's and Dementia, 2018
- Clinical Practice Guidelines and Principles of Care for People with DementiaAU/NZNHMRC Partnership Centre for Dealing with Cognitive and Related Functional Decline in Older People (Cognitive Decline Partnership Centre), University of Sydney, 2016 (Monash-led update consulted on 11 May to 6 July 2026; final not yet released)
- Updating the Clinical Practice Guidelines and Principles of Care for People with DementiaAU/NZMonash University, 2026 draft
- Neuroimaging standards for research into small vessel disease: advances since 2013 (STRIVE-2) (Duering M et al. Lancet Neurol 2023;22:602-18)The Lancet Neurology, 2023
- Prevalence, incidence, and factors associated with pre-stroke and post-stroke dementia: a systematic review and meta-analysis (Pendlebury ST, Rothwell PM. Lancet Neurol 2009;8:1006-18)The Lancet Neurology, 2009
- Effect of intensive vs standard blood pressure control on probable dementia (SPRINT MIND) (JAMA 2019;321:553-61)JAMA, 2019
- The Boston criteria version 2.0 for cerebral amyloid angiopathy (Charidimou A et al. Lancet Neurol 2022;21:714-25)The Lancet Neurology, 2022
- Australian and New Zealand Living Clinical Guidelines for Stroke ManagementAU/NZStroke Foundation (Informme), living guideline
- Dementia: assessment, management and support for people living with dementia and their carers (NG97)National Institute for Health and Care Excellence, 2018
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy