Towards defining the pathophysiological substrates of mixed dementia and vascular cognitive impairment

Masafumi Ihara¹⁾, Yoko Okamoto¹⁾,Mahito Yamada ¹⁾, Ryosuke Takahashi¹⁾, Hidekazu Tomimoto²⁾

¹⁾Department of Neurology, Kyoto University Graduate School of Medicine, ²⁾Department of Neurology, Mie University Graduate School of Medicine

Cognitive impairment resulting from cerebrovascular insufficiency has been termed vascular cognitive impairment. Vascular cognitive impairment is generally accepted to be distinct from Alzheimer’s disease resulting from a neurodegenerative process. However, this simple dichotomy may need revision in light of the apparent occurrence of several shared features between Alzheimer’s disease and vascular cognitive impairment. So-called ‘mixed’ brain pathologies, mainly comprising of Alzheimer’s pathology and cerebral infarctions, are reported to account for most dementia cases in community-dwelling elderly people. Therefore, vascular risk factors need to be controlled to achieve a reduction in the risk of dementia, even if the dementia is caused by a neurodegenerative process such as Alzheimer’s disease.

Address correspondence to Dr. Masafumi Ihara, Department of Neurology, Kyoto University Graduate School of Medicine (54 Kawahara-cho, Shogoin, Sakyo, Kyoto 606-8507, Japan)