Vascular dementia: a diagnosis running out of time.

BACKGROUND: The concept of vascular dementia has a long history but its usefulness as a diagnostic category has been called into question. AIMS: To evaluate vascular disease as a risk factor for dementia and the interface between cerebrovascular pathology and Alzheimer's disease.
METHOD: The literature on this topic was selectively reviewed and synthesised.
RESULTS: Risk factors for cerebrovascular disease are also risk factors for dementia. However, the course of dementia, once it has developed, appears to be frequently determined by Alzheimer's disease.
CONCLUSIONS: As a public health measure, modification of vascular risk represents a potentially powerful means to prevent dementia through delaying its onset. However, an effect on progression of dementia, once it has developed, has yet to be established. The traditional view of vascular dementia and Alzheimer's disease as distinguishable conditions is becoming steadily less tenable.