vascular dementia

Summary

Summary: An imprecise term referring to dementia associated with CEREBROVASCULAR DISORDERS, including CEREBRAL INFARCTION (single or multiple), and conditions associated with chronic BRAIN ISCHEMIA. Diffuse, cortical, and subcortical subtypes have been described. (From Gerontol Geriatr 1998 Feb;31(1):36-44)

Top Publications

  1. Ahtiluoto S, Polvikoski T, Peltonen M, Solomon A, Tuomilehto J, Winblad B, et al. Diabetes, Alzheimer disease, and vascular dementia: a population-based neuropathologic study. Neurology. 2010;75:1195-202 pubmed publisher
    To investigate the relation of diabetes to dementia, Alzheimer disease (AD), and vascular dementia (VaD), through analyses of incidence, mortality, and neuropathologic outcomes in a prospective population-based study of the oldest old...
  2. Roman G, Salloway S, Black S, Royall D, DeCarli C, Weiner M, et al. Randomized, placebo-controlled, clinical trial of donepezil in vascular dementia: differential effects by hippocampal size. Stroke. 2010;41:1213-21 pubmed publisher
    We sought to assess the efficacy and safety of donepezil in patients with vascular dementia (VaD) fulfilling National Institute of Neurological Disorders and Stroke-Association Internationale pour la Recherche et l'Enseignement en ..
  3. Moretti R, Torre P, Antonello R, Cazzato G, Pizzolato G. Different responses to rivastigmine in subcortical vascular dementia and multi-infarct dementia. Am J Alzheimers Dis Other Demen. 2008;23:167-76 pubmed publisher
    b>Vascular dementia (VaD) is associated with a large amount of heterogeneity, as it groups together a broad category of patients in whom various manifestations of cognitive decline are attributed to cerebrovascular or cardiovascular ..
  4. McGurn B, Deary I, Starr J. Childhood cognitive ability and risk of late-onset Alzheimer and vascular dementia. Neurology. 2008;71:1051-6 pubmed publisher
    ..A further set of controls (controls2) was generated additionally matched on paternal occupation. Vascular dementia cases had significantly lower premorbid cognitive ability (OR 0.62, 95% CI 0.41-0...
  5. Craft S. The role of metabolic disorders in Alzheimer disease and vascular dementia: two roads converged. Arch Neurol. 2009;66:300-5 pubmed publisher
    ..also proved difficult to distinguish in human patients, blurring the lines between Alzheimer disease and vascular dementia. This review highlights recent work aimed at identifying convergent mechanisms such as insulin resistance ..
  6. Cankurtaran M, Yavuz B, Cankurtaran E, Halil M, Ulger Z, Ariogul S. Risk factors and type of dementia: vascular or Alzheimer?. Arch Gerontol Geriatr. 2008;47:25-34 pubmed
    ..The aim of this study was to determine the risk factors for AD and vascular dementia (VD) in the elderly and to highlight the importance of risk factor modification in the early diagnosis...
  7. Sorrentino G, Migliaccio R, Bonavita V. Treatment of vascular dementia: the route of prevention. Eur Neurol. 2008;60:217-23 pubmed publisher
    b>Vascular dementia (VaD), rather than being considered as a univocal nosological entity, should be regarded as a heterogeneous clinical entity which differs in clinical-pathological phenotype as well as in pathophysiological mechanisms, ..
  8. Chuang Y, Hayden K, Norton M, Tschanz J, Breitner J, Welsh Bohmer K, et al. Association between APOE epsilon4 allele and vascular dementia: The Cache County study. Dement Geriatr Cogn Disord. 2010;29:248-53 pubmed publisher
    ..epsilon4 allele is an established risk factor for Alzheimer's disease, but reports of its association with vascular dementia (VaD) have been inconsistent...
  9. Steffens D, Potter G, McQuoid D, MacFall J, Payne M, Burke J, et al. Longitudinal magnetic resonance imaging vascular changes, apolipoprotein E genotype, and development of dementia in the neurocognitive outcomes of depression in the elderly study. Am J Geriatr Psychiatry. 2007;15:839-49 pubmed
    ..The association of change in white matter lesion volume and incident dementia among depressed elders extends the vascular depression hypothesis of geriatric depression to include cognitive outcomes of depression in the elderly. ..

More Information

Publications62

  1. Bombois S, Debette S, Bruandet A, Delbeuck X, Delmaire C, Leys D, et al. Vascular subcortical hyperintensities predict conversion to vascular and mixed dementia in MCI patients. Stroke. 2008;39:2046-51 pubmed publisher
    ..dementia: Alzheimer disease (AD) in 29 patients, dementia with Lewy bodies in 19, mixed dementia in 8, vascular dementia in 7, fronto-temporal dementia in 2, and primary progressive aphasia in 2...
  2. Kavirajan H, Schneider L. Efficacy and adverse effects of cholinesterase inhibitors and memantine in vascular dementia: a meta-analysis of randomised controlled trials. Lancet Neurol. 2007;6:782-92 pubmed
    Cholinesterase inhibitors and memantine do not have regulatory approval in most of the world for treatment of vascular dementia. A systematic review and meta-analysis was undertaken to assess the evidence for efficacy and safety of ..
  3. Liu H, Yang M, Li G, Qiu Y, Zheng J, Du X, et al. The MTHFR C677T polymorphism contributes to an increased risk for vascular dementia: a meta-analysis. J Neurol Sci. 2010;294:74-80 pubmed publisher
    b>Vascular dementia (VaD) is the second common cause of dementia after Alzheimer's disease (AD) in later life...
  4. Kato H, Yoshikawa T, Oku N, Imaizumi M, Takasawa M, Kimura Y, et al. Statistical parametric analysis of cerebral blood flow in vascular dementia with small-vessel disease using Tc-HMPAO SPECT. Cerebrovasc Dis. 2008;26:556-62 pubmed publisher
    Subcortical ischemic vascular dementia (SVD) caused by small-artery disease is a major cause of dementia. It still remains unclear, however, whether SVD may present with localized regional cerebral blood flow (rCBF) changes...
  5. Jokinen H, Kalska H, Ylikoski R, Madureira S, Verdelho A, van der Flier W, et al. Longitudinal cognitive decline in subcortical ischemic vascular disease--the LADIS Study. Cerebrovasc Dis. 2009;27:384-91 pubmed publisher
    ..SIVD seems to specifically contribute to the deterioration of psychomotor speed, executive control, and global cognitive function. ..
  6. Ravaglia S, Bini P, Sinforiani E, Franciotta D, Zardini E, Tosca P, et al. Cerebrospinal fluid levels of tau phosphorylated at threonine 181 in patients with Alzheimer's disease and vascular dementia. Neurol Sci. 2008;29:417-23 pubmed publisher
    In 31 patients with probable Alzheimer's disease (AD), 19 with probable vascular dementia (VaD) and 20 with Possible AD and Possible VaD, cerebrospinal fluid (CSF) tau levels hyperphosphorylated at threonine 181 (Ptau) were measured by ..
  7. Zhang G, Liu A, Zhou Y, San X, Jin T, Jin Y. Panax ginseng ginsenoside-Rg2 protects memory impairment via anti-apoptosis in a rat model with vascular dementia. J Ethnopharmacol. 2008;115:441-8 pubmed
    ..induced impairment of neurological responses, memory and caudate-putamen neuronal apoptosis in a vascular dementia (VD) rat model...
  8. Kalaria R, Maestre G, Arizaga R, Friedland R, Galasko D, Hall K, et al. Alzheimer's disease and vascular dementia in developing countries: prevalence, management, and risk factors. Lancet Neurol. 2008;7:812-26 pubmed publisher
    ..but consistently low (1-3%) in India and sub-Saharan Africa; Alzheimer's disease accounts for 60% whereas vascular dementia accounts for approximately 30% of the prevalence...
  9. Henry Feugeas M. MRI of the 'Alzheimer syndrome'. J Neuroradiol. 2007;34:220-7 pubmed
    ..Thus, MRI suggests an overestimation of AD pathology while underestimating 'arteriosclerotic brain degeneration' in the clinical picture of 'Alzheimer syndrome'. ..
  10. Likitjaroen Y, Suwanwela N, Phanthumchinda K. Vasoreactivity induced by acetazolamide in patients with vascular dementia versus Alzheimer's disease. J Neurol Sci. 2009;283:32-5 pubmed publisher
    ..This study aimed to compare the vascular reactivity in patients with vascular dementia (VaD) and Alzheimer's disease (AD)...
  11. Seripa D, Matera M, D Onofrio G, Sancarlo D, Bizzarro A, Cascavilla L, et al. Polymorphism C in the serotonin transporter gene in depression-free elderly patients with vascular dementia. Dement Geriatr Cogn Disord. 2010;29:424-31 pubmed publisher
    ..Less clear are data regarding their association with severe dementia, in particular with vascular dementia (VaD). To evaluate the possible involvement of different SLC6A4 genotypes/haplotypes in VaD...
  12. Grau Olivares M, Arboix A. Mild cognitive impairment in stroke patients with ischemic cerebral small-vessel disease: a forerunner of vascular dementia?. Expert Rev Neurother. 2009;9:1201-17 pubmed publisher
    ..Ischemic cerebral small-vessel disease should be regarded as a potentially severe condition prodrome of subcortical vascular dementia rather than a relatively benign disorder.
  13. Debette S, Bombois S, Bruandet A, Delbeuck X, Lepoittevin S, Delmaire C, et al. Subcortical hyperintensities are associated with cognitive decline in patients with mild cognitive impairment. Stroke. 2007;38:2924-30 pubmed
    ..White-matter hyperintensities and especially PVH were significantly associated with cognitive decline in MCI patients. This result was independent of the MCI subtype but stronger in cases of executive dysfunction at baseline. ..
  14. Staekenborg S, Koedam E, Henneman W, Stokman P, Barkhof F, Scheltens P, et al. Progression of mild cognitive impairment to dementia: contribution of cerebrovascular disease compared with medial temporal lobe atrophy. Stroke. 2009;40:1269-74 pubmed publisher
    ..with Alzheimer's disease, and 16 (10%) patients were diagnosed with a non-Alzheimer dementia (including vascular dementia, frontotemporal lobar degeneration, and Parkinson dementia)...
  15. Dresner Pollak R, Kinnar T, Friedlander Y, Sharon N, Rosenmann H, Pollak A. Estrogen receptor beta gene variant is associated with vascular dementia in elderly women. Genet Test Mol Biomarkers. 2009;13:339-42 pubmed publisher
    Alzheimer's disease (AD) and vascular dementia (VaD) are the main causes of dementia...
  16. Ballard C, Sauter M, Scheltens P, He Y, Barkhof F, van Straaten E, et al. Efficacy, safety and tolerability of rivastigmine capsules in patients with probable vascular dementia: the VantagE study. Curr Med Res Opin. 2008;24:2561-74 pubmed
    ..evaluate the efficacy, safety and tolerability of rivastigmine capsules in patients diagnosed with probable vascular dementia (VaD). VantagE (Vascular Dementia trial studying Exelon) was a 24-week, multicentre, double-blind study...
  17. Okamoto Y, Ihara M, Fujita Y, Ito H, Takahashi R, Tomimoto H. Cortical microinfarcts in Alzheimer's disease and subcortical vascular dementia. Neuroreport. 2009;20:990-6 pubmed publisher
    Cortical microinfarcts are reported in Alzheimer's disease, but not in subcortical vascular dementia; the disease specificity of cortical microinfarcts therefore remains unclear...
  18. Moretti R, Torre P, Antonello R, Manganaro D, Vilotti C, Pizzolato G. Risk factors for vascular dementia: hypotension as a key point. Vasc Health Risk Manag. 2008;4:395-402 pubmed
    ..Hypertension has often been observed to be a risk factor for vascular dementia (VaD) and sometimes for Alzheimer disease although not always...
  19. Romanitan M, Popescu B, Winblad B, Bajenaru O, Bogdanovic N. Occludin is overexpressed in Alzheimer's disease and vascular dementia. J Cell Mol Med. 2007;11:569-79 pubmed
    ..expression in frontal cortex (FC) and basal ganglia in ageing control, Alzheimer's disease (AD), and vascular dementia (VD) brains, as far as all these pathologies associate microangiopathy and disruption of BBB...
  20. Roe C, Fitzpatrick A, Xiong C, Sieh W, Kuller L, Miller J, et al. Cancer linked to Alzheimer disease but not vascular dementia. Neurology. 2010;74:106-12 pubmed publisher
    To investigate whether cancer is associated with Alzheimer disease (AD) and vascular dementia (VaD)...
  21. Jiwa N, Garrard P, Hainsworth A. Experimental models of vascular dementia and vascular cognitive impairment: a systematic review. J Neurochem. 2010;115:814-28 pubmed publisher
    Vascular cognitive impairment (VCI) encompasses vascular dementia and is the second most common cause of dementing illness after Alzheimer's disease...
  22. Jellinger K. The pathology of "vascular dementia": a critical update. J Alzheimers Dis. 2008;14:107-23 pubmed
    The prevalence, morphology and pathogenesis of vascular dementia (VaD), recently termed vascular cognitive disorder (VCD), are a matter of discussion.VaD is suggested in 8-15% of cognitively impaired aged subjects...
  23. Sharp S, Francis P, Elliott M, Kalaria R, Bajic N, Hortobagyi T, et al. Choline acetyltransferase activity in vascular dementia and stroke. Dement Geriatr Cogn Disord. 2009;28:233-8 pubmed publisher
    ..We examined cholinergic function at postmortem, focussing on stroke and vascular dementia (VaD)...
  24. Sekita A, Ninomiya T, Tanizaki Y, Doi Y, Hata J, Yonemoto K, et al. Trends in prevalence of Alzheimer's disease and vascular dementia in a Japanese community: the Hisayama Study. Acta Psychiatr Scand. 2010;122:319-25 pubmed publisher
    To examine secular trends in the prevalence of Alzheimer's disease (AD) and vascular dementia (VD) in a general Japanese population...
  25. Kondziella D, Göthlin M, Fu M, Zetterberg H, Wallin A. B-type natriuretic peptide plasma levels are elevated in subcortical vascular dementia. Neuroreport. 2009;20:825-7 pubmed publisher
    ..We tested the hypothesis that BNP has a more significant association with vascular dementia than Alzheimer disease...
  26. Southern L, Williams J, Esiri M. Immunohistochemical study of N-epsilon-carboxymethyl lysine (CML) in human brain: relation to vascular dementia. BMC Neurol. 2007;7:35 pubmed
    ..Accumulation of AGEs relates to risk factors for vascular dementia with ageing, including hypertension and diabetes...
  27. Staekenborg S, Su T, van Straaten E, Lane R, Scheltens P, Barkhof F, et al. Behavioural and psychological symptoms in vascular dementia; differences between small- and large-vessel disease. J Neurol Neurosurg Psychiatry. 2010;81:547-51 pubmed publisher
    The authors investigated the prevalence of behavioural and psychological symptoms in vascular dementia (VaD) from baseline data of the VantagE study and compared the severity and relative frequency of symptoms between small-vessel VaD ..
  28. Baum L, Lam L, Kwok T, Lee J, Chiu H, Mok V, et al. Apolipoprotein E epsilon4 allele is associated with vascular dementia. Dement Geriatr Cogn Disord. 2006;22:301-5 pubmed
    The apolipoprotein E (ApoE) exon 4 polymorphism has been associated with vascular dementia (VaD) risk. Since not all studies confirm this finding, we explored this association in a case-control study...
  29. Doepp F, Valdueza J, Schreiber S. Transcranial and extracranial ultrasound assessment of cerebral hemodynamics in vascular and Alzheimer's dementia. Neurol Res. 2006;28:645-9 pubmed
    ..Exact differentiation between the most common types, vascular dementia (VD) and Alzheimer's dementia (AD), is crucial to the development and application of new treatment ..
  30. Meguro K, Ishii H, Kasuya M, Akanuma K, Meguro M, Kasai M, et al. Incidence of dementia and associated risk factors in Japan: The Osaki-Tajiri Project. J Neurol Sci. 2007;260:175-82 pubmed
    ..Of the dementing diseases, 60.8% of participants developed Alzheimer' disease (AD), followed by vascular dementia (VaD), 17.9%...
  31. Parnetti L, Mignini F, Tomassoni D, Traini E, Amenta F. Cholinergic precursors in the treatment of cognitive impairment of vascular origin: ineffective approaches or need for re-evaluation?. J Neurol Sci. 2007;257:264-9 pubmed
    ..cognitive dysfunction of cerebrovascular origin, but to date they do not have specific indication for vascular dementia or vascular cognitive impairment...
  32. Chui H, Zarow C, Mack W, Ellis W, Zheng L, Jagust W, et al. Cognitive impact of subcortical vascular and Alzheimer's disease pathology. Ann Neurol. 2006;60:677-87 pubmed
    ..When Braak and Braak stage was interpolated to zero, both CVDPS and HS contributed to cognitive impairment. However, advancing stages of AD pathology overwhelmed the effects of CVDPS and HS, to become the major determinant of dementia. ..
  33. Forti P, Maioli F, Pisacane N, Rietti E, Montesi F, Ravaglia G. Atrial fibrillation and risk of dementia in non-demented elderly subjects with and without mild cognitive impairment (MCI). Arch Gerontol Geriatr. 2007;44 Suppl 1:155-65 pubmed
    ..As Alzheimer and vascular dementia (AD and VD, respectively) are thought to share many common etiopathogenetic mechanisms, we investigated ..
  34. Brown W, Moody D, Thore C, Challa V, Anstrom J. Vascular dementia in leukoaraiosis may be a consequence of capillary loss not only in the lesions, but in normal-appearing white matter and cortex as well. J Neurol Sci. 2007;257:62-6 pubmed
    ..In the four irradiated brains, we found very low vessel densities, similar to those found in LA, without an additional age-related decline...
  35. Zimny A, Sasiadek M, Leszek J, Czarnecka A, Trypka E, Kiejna A. Does perfusion CT enable differentiating Alzheimer's disease from vascular dementia and mixed dementia? A preliminary report. J Neurol Sci. 2007;257:114-20 pubmed
    ..study was to evaluate the usefulness of perfusion CT (pCT) in differentiating Alzheimer's disease (AD) from vascular dementia (VaD) and mixed dementia (MixD). pCT was performed in 41 patients (mean age, 68...
  36. Allan L, Ballard C, Allen J, Murray A, Davidson A, McKeith I, et al. Autonomic dysfunction in dementia. J Neurol Neurosurg Psychiatry. 2007;78:671-7 pubmed
    There are no studies of autonomic function comparing Alzheimer's disease (AD), vascular dementia (VAD), dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD)...
  37. Kerber K, Whitman G, Brown D, Baloh R. Increased risk of death in community-dwelling older people with white matter hyperintensities on MRI. J Neurol Sci. 2006;250:33-8 pubmed
    ..Severe WMH increase the risk of death, even in community-dwelling elderly without stroke or other neurological disease, independent of other covariates including hypertension, age, and coronary artery disease. ..
  38. Corzo L, Zas R, Rodriguez S, Fernandez Novoa L, Cacabelos R. Decreased levels of serum nitric oxide in different forms of dementia. Neurosci Lett. 2007;420:263-7 pubmed
    ..dysfunction have been recognized as contributing factors in the pathogenesis of Alzheimer disease (AD) and vascular dementia (VD)...
  39. Vicenzini E, Ricciardi M, Altieri M, Puccinelli F, Bonaffini N, Di Piero V, et al. Cerebrovascular reactivity in degenerative and vascular dementia: a transcranial Doppler study. Eur Neurol. 2007;58:84-9 pubmed
    ..both in normal ageing and in senescence-associated processes, as well as in Alzheimer's disease (AD) and vascular dementia (VaD)...
  40. Jeong B, Na H, Bae J, Lee K, Lee Y, Kim N, et al. Absence of association between codon 129 and 219 polymorphisms of the prion protein gene and vascular dementia. Dement Geriatr Cogn Disord. 2007;24:86-90 pubmed
    ..However, an association between PRNP polymorphisms and vascular dementia (VaD) has not been reported thus far...
  41. Zuliani G, Ranzini M, Guerra G, Rossi L, Munari M, Zurlo A, et al. Plasma cytokines profile in older subjects with late onset Alzheimer's disease or vascular dementia. J Psychiatr Res. 2007;41:686-93 pubmed
    ..A possible increase in plasma cytokines levels has been reported in LOAD and vascular dementia (VD), but the results of previous studies are conflicting...
  42. Birkenhäger W, Staessen J. Progress in cardiovascular diseases: cognitive function in essential hypertension. Prog Cardiovasc Dis. 2006;49:1-10 pubmed
    ..recognized as a major factor in the development of the 2 main types of dementia, that is, no longer merely vascular dementia but Alzheimer disease as well...
  43. Waragai M, Takeuchi H, Fukushima T, Haisa T, Yonemitsu T. MRI and SPECT studies of dural arteriovenous fistulas presenting as pure progressive dementia with leukoencephalopathy: a cause of treatable dementia. Eur J Neurol. 2006;13:754-9 pubmed
    ..DAVFs may be particularly important for differential diagnosis in elderly patients with pure progressive dementia. Thus, early diagnosis of DAVFs and treatment by endovascular surgery is important as treatable or reversible dementia. ..
  44. Smith M, Wells J, Borrie M. Treatment effect size of memantine therapy in Alzheimer disease and vascular dementia. Alzheimer Dis Assoc Disord. 2006;20:133-7 pubmed
    ..of the significant results reported in clinical trials of memantine therapy for Alzheimer disease (AD) and vascular dementia. We sought to understand what clinically detectable changes would be evident to the patient with dementia, ..
  45. Gawel M, Zalewska E, Szmidt Sałkowska E, Kowalski J. Does EEG (visual and quantitative) reflect mental impairment in subcortical vascular dementia?. J Neurol Sci. 2007;257:11-6 pubmed
    ..of visual and quantitative EEG (QEEG) parameters reveal a correlation with mental impairment in subcortical vascular dementia (SVD), one of the most frequent causes of cognitive impairment in the elderly...
  46. Hanon O, Pequignot R, Seux M, Lenoir H, Bune A, Rigaud A, et al. Relationship between antihypertensive drug therapy and cognitive function in elderly hypertensive patients with memory complaints. J Hypertens. 2006;24:2101-7 pubmed
    ..cognitive status: normal cognitive function, mild cognitive impairment (MCI), Alzheimer's disease (AD) or vascular dementia (VaD)...
  47. Farlow M. Use of antidementia agents in vascular dementia: beyond Alzheimer disease. Mayo Clin Proc. 2006;81:1350-8 pubmed
    b>Vascular dementia (VaD) is the second leading cause of dementia and is often underdiagnosed. Stroke is the leading cause of VaD, although it may also develop secondary to a variety of other cerebrovascular or cardiovascular conditions...
  48. Krzystanek E, Krzystanek M, Opala G, Trzeciak H, Siuda J, Małecki A. Platelet phospholipase A2 activity in patients with Alzheimer's disease, vascular dementia and ischemic stroke. J Neural Transm (Vienna). 2007;114:1033-9 pubmed
    ..the present study we investigated PLA(2) activity in platelets from 37 Alzheimer's disease (AD) patients, 32 vascular dementia (VaD) patients and 32 individuals with ischemic stroke as compared to 27 healthy elderly controls...
  49. Francis P. Targeting cell death in dementia. Alzheimer Dis Assoc Disord. 2006;20:S3-7 pubmed
    Neuronal degeneration is a key feature of both Alzheimer disease (AD) and vascular dementia (VaD)...
  50. Micieli G. Vascular dementia. Neurol Sci. 2006;27 Suppl 1:S37-9 pubmed
    Epidemiological, clinical, neuropsychological and neuroimaging features characterise vascular dementia (VaD) from other dementias of non-Alzheimer type...
  51. Flex A, Gaetani E, Proia A, Pecorini G, Straface G, Biscetti F, et al. Analysis of functional polymorphisms of metalloproteinase genes in persons with vascular dementia and Alzheimer's disease. J Gerontol A Biol Sci Med Sci. 2006;61:1065-9 pubmed
    b>Vascular dementia (VAD) and Alzheimer's disease (AD) may share common neuropathological mechanisms. Matrix metalloproteinases (MMPs) may induce destruction of the extracellular matrix, neuronal dysfunction, and death...
  52. Hayden K, Zandi P, Lyketsos C, Khachaturian A, Bastian L, Charoonruk G, et al. Vascular risk factors for incident Alzheimer disease and vascular dementia: the Cache County study. Alzheimer Dis Assoc Disord. 2006;20:93-100 pubmed
    Vascular risk factors for Alzheimer disease (AD) and vascular dementia (VaD) have been evaluated; however, few studies have compared risks by dementia subtypes and sex...
  53. Korczyn A, Vakhapova V. The prevention of the dementia epidemic. J Neurol Sci. 2007;257:2-4 pubmed
    ..Another disorder, vascular dementia (VaD), is a syndrome with multiple etiologies operating through a variety of different mechanisms...