Vascular dementia - Diagnosis, prevention and treatment

Objective: In this article, current trends in diagnosis, prevention and therapy of vascular dementias (VaD) are summarized. Methods: Based on the conceptual background and pathophysiology of VaD, current diagnostic approaches and results from recent large-scale randomised preventative and therapeutic studies are reviewed. Results: Epidemiological cohort studies and first intervention trials with anithypertensive drugs demonstrated the usefulness of antihypertensive drugs in the prevention of dementia. For the treatment of manifest VaD, no pharmaceutical substance has been approved to date, despite positive results in controlled studies with acetylcholinestere inhibitors. Conclusions: Long-term control of vascular risk factors before dementia has occurred appears to be the most important strategy to reduce the incidence of VaD.