Introduction     Diagnosis of Mild Cognitive Impairment and Alzheimer's Disease Karen L. Bell, M.D.     Treatment Strategies for Dementia and Mild Cognitive Impairment Mary Sano, Ph.D.     Treatment of Depression, Agitation, and Psychosis in Dementia Davangere P. Devanand, M.D.     Recognition of Vascular Dementia, Dementia with Lewy Bodies, and Frontotemporal Dementia Lawrence S. Honig, M.D., Ph.D.     Categorization of Dementias       Prevalence of Non-Alzheimer's Dementias       The Spectrum of Lewy-Body Disease       Frontotemporal Dementia       Other Frontotemporal Dementia       Vascular Dementia       Other Non-Alzheimer's Dementias         Neuropsychology of Mild Cognitive Impairment, Alzheimer's Disease, Dementia with Lewy Bodies, and Frontotemporal Dementia Penne Sims, Ph.D.     Neuroimaging in Dementia Scott A. Small, M.D.     Genetics of Neurodegenerative Disease: Alzheimer's Disease, Frontotemporal Dementia Jennifer Williamson-Catania, M.S.     Legal and Ethical Issues for Patients with Dementia Daniel G. Fish, Esq.     Posttest         Accreditation     Reference List     Acknowledgements		Recognition of Vascular Dementia, Dementia with Lewy Bodies, and Frontotemporal Dementia Lawrence S. Honig, M.D., Ph.D. Vascular Dementia   The frequency of strokes among the elderly makes vascular dementia difficult to diagnose. Consensus criteria recognize various syndromes including of multiple infarcts, strategic single infarcts, small-vessel disease, global hypoperfusion, and others.         Vascular Dementia NINDS-AIREN 1993 Specific Types 1. Multi-infarct dementia (large-vessel infarcts) 2. Strategic single-infarct dementia (PCA, ACA, B thalamic, BF) 3. Small-vessel disease with dementia-multiple lacunes (basal ganglia, frontal WM, PVWM = Binswanger's) 4. Hypoperfusion (global 2° to arrest or hypotension; watershed) 5. Hemorrhagic dementia (chronic SDH, SAH, ICH, ±CAA) 6. Other mechanisms (combinations of above, or unknown)   The most accepted criteria for vascular dementia are the 1993 NINDS-AIREN criteria. Courtesy of Dr. Lawrence Honig     The most accepted criteria for vascular dementia are the 1993 NINDS-AIREN criteria. These require dementia and strokes. (This might be obvious, although it is surprising how many people are classified as having vascular dementia who do not actually have strokes.) There must be a relationship between the dementia and the strokes. This can be complicated and controversial, since if someone has Alzheimer's disease and has a superposed stroke , their symptoms may become a lot worse. Many people may meet these criteria who do not, neuropathologically speaking, have a pure vascular dementia. The majority of cases thought to have vascular dementia actually have a mixture of Alzheimer's disease and cerebral vascular disease; true "pure" vascular dementia in pathology series is fairly rare. Dr. Sano mentioned the usefulness of Alzheimer's treatments in persons with mixtures of Alzheimer's disease and vascular disease, which appears to be greater than the usefulness in those cases that seem to be more purely vascular. However, even among those cases thought to be purely vascular (one-third of the cases in the study that Dr. Sano showed), there are likely many mixed cases.     PREVIOUS | NEXT