Vascular Dementia

       Vascular dementia is a heterogeneous group of conditions that includes all of dementia syndromes caused by ischemia, hemorrhage, anoxic or hypoxic brain with cognitive impairment ranging from mild to the most severe, and not necessarily with a prominent memory impairment.
Vascular dementia consists of three subtypes, namely:
1. Post-stroke dementia include vascular dementia caused by local infarction, multi-infarct dementia, and stroke due to bleeding. Usually have a clear correlation between the occurrence of stroke with dementia.
2. Subcortical vascular dementia, which includes myocardial lacunar and Binswanger disease, with the incidence of transient ischemic attack (TIA) or stroke are often not detected but have vascular risk factors.
3. Mixed type of dementia, is dementia with vascular pathology in combination with Alzheimer's dementia (AD).

       The most frequent type of dementia other than Alzheimer's disease is vascular dementia, which is causative of dementia related to cerebrovascular disease. Vascular dementia amount to 15-30 percent of all cases of dementia. Vascular dementia is most often found in people between the ages of 60-70 years and more frequently in men than women. Hypertension predisposes a person to the disease.

The Types of vascular dementia based clinically are as follows:
1. Vascular dementia after stroke
For dementia due to certain myocardial lesions will be found in angular gyrus, thalamus, basal forebrain, the area around the posterior cerebral artery, and anterior cerebral artery. As for the Multiple Infarction Dementia (MID) will get the intracerebral hemorrhage.
2. Subcortical vascular dementia
There ischemic lesions in the substantia alba, lakuner subcortical infarction, non lacunar subcortical infarction.
3. Mixed type of vascular dementia of Alzheimer's disease and cerebrovascular disease
 
EPIDEMIOLOGY
        In western countries, vascular dementia is the second highest after Alzheimer's disease. However, since vascular dementia is the most type of dementia in some Asian countries with large population, so vascular dementia is a most type of dementia in the world.
      The prevalence of vascular dementia are vary between countries, but the prevalence found in most developed countries. The prevalence rate of dementia is 9 times higher in patients ever had stroke. One year after stroke, 25% of patients come in with a new onset of dementia. In Canada, the incidence rate at age ≥ 65 years the amount of 2.52 per 1000 population, while the prevalence of vascular dementia in Japan magnitude of 4.8%. The European Community Concerted Action on the Epidemiology and Prevention of Dementia gain prevalence ranging from 1.5 / 100 women aged 75-79 years in England up to 16.3 / 100 men over the age of 80 years in Italy.
      Vascular dementia is dementia can be prevented so as to have a major role in reducing the incidence of dementia and improving quality of life for elderly people.

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