Cerebrovascular disease and dementia.

Abstract

Cerebrovascular disease and dementia are extremely prevalent and disabling disorders affecting older people. Results of previous pathological investigations and later epidemiological studies have raised the possibility that the two disorders may be causally related. The study of such causal associations may provide insights that could lead to the development of strategies intended to prevent or treat dementia more effectively. Cerebrovascular disease has many manifestations, some of which are strong causal factors in the development of a future dementia. However, uncertainty and controversy exist regarding the presence and nature of the causal contribution of others. Potential therapeutic strategies for dementia are hindered by the lack of understanding of such relationships and the consequent difficulty in identifying a clear phenotype of dementia occurring predominantly due to cerebrovascular disease. The field is ripe for further examination of the associations between vascular factors and dementia, and the mechanisms underlying such associations. The interface between basic and clinical science has much to offer in clarifying the relationships between aging, vascular factors and cognitive decline in older people. In this review, we will attempt to synthesize data available from epidemiological, clinical and basic science research in the field of dementia related to cerebrovascular disease, highlighting potential avenues for further research.