Vascular dementia

Abstract

Criteria for the diagnosis of vascular dementia (VaD) that are reliable, valid, and readily applicable in a variety of settings are urgently needed for both clinical and research purposes. To address this need, the Neuroepidemiology Branch of the National Institute of Neurological Disorders and Stroke (NINDS) convened an International Workshop with support from the Association Internationale pour la Recherche et l'Enseignement en Neurosciences (AIREN), resulting in research criteria for the diagnosis of VaD. Compared with other current criteria, these guidelines emphasize (1) the heterogeneity of vascular dementia syndromes and pathologic subtypes including ischemic and hemorrhagic strokes, cerebral hypoxic-ischemic events, and senile leukoencephalopathic lesions; (2) the variability in clinical course, which may be static, remitting, or progressive; (3) specific clinical findings early in the course (eg, gait disorder, incontinence, or mood and personality changes) that support a vascular rather than a degenerative cause; (4) the need to establish a temporal relationship between stroke and dementia onset for a secure diagnosis; (5) the importance of brain imaging to support clinical findings; (6) the value of neuropsychological testing to document impairments in multiple cognitive domains; and (7) a protocol for neuropathologic evaluations and correlative studies of clinical, radiologic, and neuropsychological features. These criteria are intended as a guide for case definition in neuroepidemiologic studies, stratified by levels of certainty (definite, probable, and possible). They await testing and validation and will be revised as more information becomes available.

Albuminuria Increases the Risks for Both Alzheimer Disease and Vascular Dementia in Community‐Dwelling Japanese Elderly: The Hisayama Study

“…Subjects diagnosed with AD met the criteria of the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association,18 and subjects diagnosed with VaD met the criteria of the National Institute of Neurological Disorders and Stroke‐Association Internationale pour la Recherche et l'Enseignement en Neurosciences 19. Clinical information, including neuroimaging, was used to diagnose possible and probable dementia subtypes.…”

Neuropsychiatric Symptoms as Risk Factors for Progression From CIND to Dementia: The Cache County Study

“…Diagnosis of AD was made according to NINCDS-ADRDA criteria 28 . Vascular dementia diagnoses followed the NINDS-AIREN criteria 29 . Other dementia diagnoses included: diffuse Lewy body dementia, Parkinson's Disease, frontotemporal dementia, traumatic brain injury, alcoholic dementia, and dementia of undetermined etiology.…”

Background and distribution of lobar microbleeds in cognitive dysfunction

“…For AD, we used the criteria for probable AD of the National Institute of Neurologic Disorders and Stroke‐Alzheimer Disease and Related Disorders Association (NINCDS‐ADRDA) (McKhann et al., 1984) and for AD with CVD by Bruandet et al. (2009), and for vascular dementia (VaD), the criteria for probable VaD of the National Institute of Neurological Disorders and Stroke‐Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS‐AIREN) (Román et al., 1993). For MCI, we used the general criteria of the International Working Group on MCI (Winblad et al., 2004), for DLB, the clinical criteria of the consortium on DLB (McKeith et al., 2005), for frontotemporal lobar degeneration, the Lund‐Manchester criteria for frontotemporal dementia, progressive nonfluent aphasia, and semantic dementia (Neary et al., 1998).…”