Vascular Disease, Alzheimer’s. Disease, and Mild Cognitive Impairment: Advancing an Integrated Approach

Alzheimer’s disease and vascular dementia are acknowledged as the two most common types of dementia. Each of these dementia syndromes are associated with prodromal clinical syndromes, often referred to as mild cognitive impairment. Recent research has demonstrated considerable heterogeneity regarding the underlying neuropathology associated with these dementia syndromes and their prodromal disorders. Thus, it is often difficult to understand how or what underlying biological substrate is actually responsible for the alterations in neurocognition and behaviour as seen in clinical evaluations. This inherent neuropsychological and neuropathology heterogeneity calls into question current paradigms used for diagnosis and clinical trials designed to treat these disorders. This volume summarizes our current understanding regarding the inherent clinical, neuropathological, and biological heterogeneity in Alzheimer’s disease, vascular dementia, and mild cognitive impairment and suggests that these disorders are best viewed as existing along a continuum rather than treated as separate and distinct clinical syndromes. In this book, we put forth the point of view that dementia such as Alzheimer’s disease and vascular dementia; and subtle pre-dementia syndromes such as mild cognitive impairment are best viewed as existing along a continuum rather than distinct and separate disorders.