Vascular dementia (VaD) is the second most common subtype of dementia in Western countries
(Desmond, 1996) and, overall, may be the most common subtype of dementia in the world
(Henderson, 1994). Furthermore, the recognition of some major risk factors of cerebrovascular
disease makes VaD a form of ‘preventable senility’ (Hachinski, 1992). The last decade has seen a
major re-evaluation of the concept of VaD (Erkinjuntti & Hachinski, 1993; Hachinski, 1994), with
new diagnostic criteria having been proposed (World Health Organization, 1993; American
Psychiatric Association, 1994) but without any consensus (Wetterling et al. 1996). Indeed, some
investigators have called for the abandonment of the diagnosis of VaD and the adoption of
alternative nosology (Hachinski, 1994). It is therefore time to re-examine the concept of VaD and
evaluate its distinctive features.