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Vascular Dementia and Binswanger Disease
Definition
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Vascular dementias are a group of chronic progressive dementing disorders resulting from hypoperfusive, occlusive, or hemorrhagic cortical or subcortical infarcts
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Binswanger disease (subcortical vascular dementia) refers to a widespread small-vessel disease affecting the deep white matter usually associated with systemic hypertension with atherosclerosis and arteriolosclerosis
Clinical Features
Epidemiology
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Vascular dementias are the second most common cause of senile dementia
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Usually presents in patients >60 years old
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No gender predominance
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Estimated prevalence of 8% to 15% of older adults
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Overall estimated incidence 3.8 per 1000 persons per year; age >80 incidence increases to 6 to 50 per 1000 persons per year
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Risk factors include older age, hypertension, smoking, diabetes
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Binswanger disease (note significant overlap with “vascular dementia” noted earlier)
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Presents in 50 to 60 age range
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No gender predominance
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Overall estimated incidence 2.5 to 3.5 per 1000 individuals per year (6 to 12 per 1000 in ages >70)
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Association with hypertension and atherosclerosis
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