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Vascular Dementia and Alzheimer's Disease: Is There a Difference?

A Comparison of Symptoms by Disease Duration

Received May 3, 1999; revised November 22, 1999; accepted December 2, 1999. From the Neuropsychiatry and Memory Group, Department of Psychiatry and Behavioral Sciences, School of Medicine, The Johns Hopkins University, Baltimore, Maryland; and Copper Ridge Institute, Sykesville, Maryland. Address correspondence to Dr. Lyketsos, The Johns Hopkins Hospital, 600 North Wood Street/Osler 320, Baltimore, MD 21287; e-mail: kostas{at}jhmi.edu

This study examined differences between vascular dementia (VaD) by the NINDS/AIRENS criteria and Alzheimer's disease (AD) on clinical grounds. A consecutive series of 517 patients with probable and possible VaD or AD were evaluated for cognitive, functional, and behavioral symptoms and separated into three subgroups by duration of dementia. These AD and VaD subgroups were then compared on a series of standardized clinical measures. The only consistent trends were for VaD patients to be more depressed, more functionally impaired, and less cognitively impaired within each disease duration subgroup. The authors conclude that there are few differences between clinically diagnosed VaD and AD. Subclassification of VaD into subgroups will improve the clinical utility of this nosologic entity.

Key Words: Alzheimer's Disease • Dementia, Vascular • Nosology

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