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Criteria for the diagnosis of ischemic vascular dementia proposed by the State of California Alzheimer's Disease Diagnostic and Treatment Centers
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Cerebrovascular DiseaseGeriatric NeurologyNeurovascular DiseaseAlzheimer's DiseaseStroke RehabilitationCalifornia AlzheimerNeurologyAging-associated DiseasePublic HealthNeuropathologyIschemic Vascular DementiaMedicineNeuroepidemiologyNeurological MonitoringVascular DementiaDisease DiagnosticCerebral Blood FlowNeurological AssessmentEpidemiologyNeurodegenerative DiseasesIschemic StrokeVascular Cognitive DisorderDementiaNeuroscienceAddtc CriteriaAccurate DiagnosisStroke
Accurate diagnosis of vascular dementia is essential for identifying underlying pathology, guiding therapy, and accurately estimating its incidence and prevalence, especially given the difficulty of distinguishing it from Alzheimer’s disease. The California ADDTC proposes new criteria for diagnosing ischemic vascular dementia and recommends using parallel “possible” and “mixed” categories for both AD and IVD to align with NINCDS standards. The criteria employ parallel definitions of “possible” and “mixed” categories to ensure compatibility between ADDTC IVD criteria and NINCDS AD criteria. The proposed criteria expand the definition of vascular dementia, incorporate neuroimaging results, emphasize neuropathologic confirmation, refine nosology, identify research gaps, and promote uniform subtype classification to enhance study generalizability and facilitate multicenter collaboration.
Accurate diagnosis of vascular dementia is important for the recognition of underlying pathophysiology and the institution of appropriate therapy. It is also important for the determination of the incidence and prevalence of not only vascular dementia but also Alzheimer9s disease (AD), since differentiating between these two entities is often problematic. The State of California Alzheimer9s Disease Diagnostic and Treatment Centers (ADDTC) herein propose criteria for the diagnosis of ischemic vascular dementia (IVD). These criteria broaden the conceptualization of vascular dementia, include the results of neuroimaging studies, emphasize the importance of neuropathologic confirmation, refine nosology, and identify areas that require further research. Parallel use of the proposed definitions of “possible” and “mixed” categories in the diagnosis of both AD and IVD would ensure compatibility between the National Institute of Neurological and Communicative Disorders and Stroke (NINCDS) criteria for AD and the ADDTC criteria for IVD. Uniform classification of subtypes of IVD will improve the generalizability of individual studies and aid in multicenter collaborations.