ABSTRACT
Alzheimer’s disease (AD) remains the dominant cause of dementia in the elderly. However, owing to the high prevalence of ischemic heart, and cerebrovascular, disease in this age group, the second most common cause of dementia or cognitive decline in the elderly is vascular dementia (VaD) (Rocca et al, 1991). Other chapters of this book give detailed descriptions of VaD, its etiology, whether resulting from ischemia, hypoperfusion or hemorrhagic cerebrovascular disease with or without additional cardiac or circulatory disorders. In any discussion on the treatment of cognitive decline in VaD the clinical relevance of its distinction from AD arises and is challenged by the evidence that it is not as great as was once supposed. In fact both pathologies occur together more commonly than VaD alone (Holmes et al, 1999). It follows then that current treatments for AD may have an important part to play in mixed dementia and consequently the attention of those preoccupied with the development of cholinesterase inhibitors (ChEIs) has included VaD in the last five years.
