Prognosis

The rate of progression of cognitive impairment in vascular dementia is variable; some patients progress at a slower rate than patients with Alzheimer disease. The mortality rate, however, is higher in patients with vascular dementia than in patients with Alzheimer disease, with 50% of patients with vascular dementia not living longer than 4 years.

While waiting for effective drug therapies and first-level evidence data, healthcare professionals should be encouraged to improve early diagnosis of cognitive impairment and activate control strategies against vascular disease and unhealthy lifestyle habits.

Patient Education

Once the diagnosis of dementia is established, patients and patients' families should be educated about the nature of the condition with great sensitivity. The clinician should balance his or her explanation to avoid provoking negative reactions from the patient or the family.

Potentially dangerous activities (eg, driving) should be discussed; provide advice regarding possible interventions (eg, driving evaluation).

The patient should be advised about electing a power of attorney in case the patient becomes incapacitated.

Caregivers require support as well. Provide contact information to caregivers for the local chapter of the Alzheimer's Association, which organizes support groups for caregivers of individuals with dementia.

For excellent patient education resources, visit eMedicineHealth's Brain and Nervous System Center. Also, see eMedicineHealth's patient education articles Dementia Overview, Dementia Medication Overview, Alzheimer Disease, Stroke, and Stroke-Related Dementia.

Questions

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Author

Jasvinder Chawla, MD, MBA Chief of Neurology, Hines Veterans Affairs Hospital; Professor of Neurology, Loyola University Medical Center

Jasvinder Chawla, MD, MBA is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, American Clinical Neurophysiology Society, American Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Jaime Grutzendler, MD Assistant Professor, Department of Neurology and Physiology, Northwestern University School of Medicine

Jaime Grutzendler, MD is a member of the following medical societies: American Academy of Neurology, Society for Neuroscience

Disclosure: Nothing to disclose.

Giovanni d'Avossa, MD Lecturer, School of Psychology, Bangor University; NHS Honorary Consultant in Neurology

Disclosure: Nothing to disclose.

Fredy J Revilla, MD, FAAN, FANA Clinical Professor, University of South Carolina School of Medicine, Greenville; Chief, Division of Neurology, UMG Neuroscience Associates, Prisma Health-Upstate

Fredy J Revilla, MD, FAAN, FANA is a member of the following medical societies: American Academy of Neurology, American Neurological Association, Huntington Study Group, International Parkinson and Movement Disorder Society, Parkinson Study Group, Society for Neuroscience

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Jorge C Kattah, MD Head, Associate Program Director, Professor, Department of Neurology, University of Illinois College of Medicine at Peoria

Jorge C Kattah, MD is a member of the following medical societies: American Academy of Neurology, American Neurological Association, New York Academy of Sciences

Disclosure: Nothing to disclose.

Chief Editor

Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM Adjunct Associate Professor of Neurology, University of Missouri-Columbia School of Medicine; Medical Director of St Mary's Stroke Program, SSM Neurosciences Institute, SSM Health

Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM is a member of the following medical societies: American Academy of Neurology, American Association of Neuromuscular and Electrodiagnostic Medicine, American Headache Society

Disclosure: Nothing to disclose.

Additional Contributors

Christopher Luzzio, MD Clinical Assistant Professor, Department of Neurology, University of Wisconsin at Madison School of Medicine and Public Health

Christopher Luzzio, MD is a member of the following medical societies: American Academy of Neurology

Disclosure: Nothing to disclose.

Sections Neurological Manifestations of Vascular Dementia
Overview
Presentation
- History
- Physical
- Causes
- Show All
DDx
Workup
Treatment
Medication
Follow-up
Questions & Answers
References

Neurological Manifestations of Vascular Dementia Follow-up

Prognosis

Patient Education

References

Tables

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