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Vascular dementia is one of the most common causes of dementia after Alzheimers disease, causing around 15% of cases. However, unlike Alzheimers disease, there are no licensed treatments for vascular dementia. Progress in the specialty has been difficult because of uncertainties over disease classification and diagnostic criteria, controversy over the exact nature of the relation between cerebrovascular pathology and cognitive impairment, and the paucity of identifiable tractable treatment targets. Although there is an established relation between vascular and degenerative Alzheimers pathology, the mechanistic link between the two has not yet been identified. This Series paper critiques some of the key areas and controversies, summarizes treatment trials so far, and makes suggestions for what progress is needed to advance our understanding of pathogenesis and thus maximize opportunities for the search for new and effective management approaches. |
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