Vaskuläre Demenz

Besides Alzheimer’s disease, major and mild vascular cognitive impairment (VCI) belong to the most frequent reasons for cognitive decline in the elderly population. The clinical diagnosis of probable major VCI requires the presence of dementia and evidence of relevant cerebrovascular lesions (magnetic resonance imaging is recommended) with corresponding clinical neurological signs. The high frequency of “mixed” pathologies (mostly concomitant Alzheimer’s disease) may significantly complicate the evaluation of diagnostic findings. The pharmacological treatment of vascular dementia is limited to the treatment of vascular risk factors. Nonetheless, various differential diagnoses and clinical mimics may be reversible or effectively treatable. Thus, the suspicion of VCI requires a thorough diagnostic work-up, including the assessment of the Alzheimer’s biomarker profile and the exclusion of central nervous system inflammation.