Vascular dementia

[Zipporah Schumaker]

Vascular dementia is acute or chronic cognitive deterioration due to diffuse or focal cerebral infarction that is most often related to cerebrovascular disease.
(See also Overview of Delirium and Dementia and Dementia.)
Dementia is chronic, global, usually irreversible deterioration of cognition.
Vascular dementia is the 2nd most common cause of dementia among older people. It is more common among men and usually begins after age 70. It occurs more often in people who have vascular risk factors (eg, hypertension, diabetes mellitus, hyperlipidemia, smoking) and in those who have had several strokes. Many people have both vascular dementia and Alzheimer disease.
Dementia should not be confused with delirium, although cognition is disordered in both. The following helps distinguish them:

Dementia affects mainly memory, is typically caused by anatomic changes in the brain, has slower onset, and is generally irreversible.
Delirium affects mainly attention, is typically caused by acute illness or drug toxicity (sometimes life threatening), and is often reversible.

Other specific characteristics also help distinguish the 2 disorders (see table Differences Between Delirium and Dementia).