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Vascular Dementia
  1. F-E de Leeuw,
  2. J. van. Gijn
  1. Department of Neurology, University Medical Centre Utrecht, The Netherlands; E-mail h.f.deleeuw{at}



Vascular dementia is one of the most frequent causes of dementia in the elderly and therefore a major burden on health care systems in ageing societies. Cognitive dysfunction frequently occurs after a clinically obvious ischaemic or haemorrhagic stroke, and even a subclinical or ‘silent’ stroke, and ranges from subjective memory complaints that cannot be detected even by detailed neuropsychological examination, to full-blown dementia (Tatemichi et al. 1992; Van Zandvoort et al. 1998). The diagnosis of vascular dementia may be difficult because the temporal relation between a stroke first and then the occurrence of cognitive decline is not always obvious at first sight. This may be because the stroke was silent, or it may be difficult to relate the location of the stroke lesion to the cognitive consequences. In addition, in Alzheimer’s disease vascular events in the brain may worsen its course and confuse any diagnostic classification (Pasquier et al.

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