chapter  58
What is vascular cognitive impairment?
ByTimo Erkinjuntti, Leonardo Pantoni, Susanna Melkas
Pages 13

As early as 1896, ‘arteriosclerotic dementia’ (referring to vascular dementia [VaD]) was separated from ‘senile dementia’ (referring to Alzheimer’s disease [AD]). Alois Alzheimer together with Otto Binswanger recognized the heterogeneity of VaD by describing four clinical-pathological subtypes of VaD (Roman, 2001), as well as vascular lesions in AD. Nevertheless, until the 1970s cerebral atherosclerosis causing chronic decrease of blood supply to the brain was thought to be the commonest cause of dementia, and AD was regarded as a rare cause aecting only younger patients. Tomlinson et al. (1970) reinvented AD as the most frequent cause of dementia. Hachinski et al. (1974) used the term multi-infarct dementia (MID) to describe the mechanism by which they considered VaD was produced. As the pendulum swung in the direction of AD, vascular forms of dementia became relegated to a position of relative obscurity (Brust, 1988).