4 - Cognitive functioning in vascular dementia before and after diagnosis

Summary

This chapter focuses on cognitive functioning in multi-infarct dementia (MID) and subcortical (small-vessel disease) vascular dementia (VaD), the most extensively studied subtypes. An important difference in the manifestation of subcortical VaD compared to MID is the effect of a single infarct on cognition. Frontal-executive function and episodic memory are two cognitive domains frequently assessed when trying to discriminate between VaD and other dementia types, and between different VaD subtypes. The chapter describes these domains in more detail, as well as their manifestation in VaD. One of the challenges in clinical practice is to separate between VaD and other dementia types, most often Alzheimer's disease (AD). Future studies should seek to study the whole range of cognitive impairments associated with cerebrovascular disease (CVD), especially the earlier stages when the person still does not fulfill the criteria for dementia. This is where interventions would render the largest benefits.