A historical review of the concept of vascular dementia: lessons from the past for the future.

The history of senile dementia begins in the Greco-Roman period with basic concepts of senility by Pythagoras and Hippocrates. During the Middle Ages, the main contribution was by Roger Bacon in 1290. The first textbook of neurology, De cerebri morbis, by Jaso de Pratis (1549), included a chapter on dementia ("De memoriae detrimento"). In the 17th century, Thomas Willis recognized intellectual loss with aging. In the 19th century, Philippe Pinel removed chains from the mentally ill; his student Esquirol wrote the first modern classification of mental disease, including senile dementia. In 1860, Morel recognized brain atrophy with aging. The modern history of vascular dementia began in 1896, when Emil Kraepelin in his textbook Psychiatrie included "arteriosclerotic dementia" among the senile dementias, following the ideas of Otto Binswanger and Alois Alzheimer, who had differentiated clinically and pathologically arteriosclerotic brain lesions from senile dementia and from neurosyphilitic general paresis of the insane. Binswanger's and Alzheimer's contributions are reviewed in detail.