ABSTRACT
As with Alzheimer’s disease (AD), patients with vascular dementia (VaD) and vascular cognitive impairment will often present to clinicians because of cognitive deficits, either manifest directly or through problems such as impaired functioning. However, in marked contrast to AD, in patients presenting with a vascular cognitive deficit, memory is often not the first function affected, indeed such cases are more likely to present with impairments in executive function and information processing. In clinical practice patients may also present with one or more of the many noncognitive symptoms that occur in dementia, e.g. depressed mood, apathy, behavioral disturbances and psychosis. When patients develop such psychopathological phenomena clinicians should be alert to the possibility, especially in older people, that a dementing illness may be present. Such noncognitive symptoms are dealt with in detail in Chapter 18. Before addressing the assessment process itself three preliminary matters will be considered.
