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Demens, vaskulær

Sist revidert:
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Definisjon:
Vaskulær demens er et demenssyndrom forårsaket av cerebrovaskulær eller kardiovaskulær sykdom som medfører hjerneskade eller -funksjonsforstyrrelse. Noe uenighet om kriteriene for diagnosen
Forekomst:
Etter Alzheimers demens er vaskulær demens nest hyppigste demensform i Norge med ca. 15-20 % av demenstilfellene. Debuterer vanligvis sent i livet. Hyppig komorbiditet med Alzheimers sykdom. 
Symptomer:
Tilstanden kjennetegnes ved psykomotorisk svekkelse, oppmerksomhetsproblemer, tap av eksekutive funksjoner og personlighetsendringer
Funn:
Kliniske demenskriteriene er oppfylt. Tegn på cerebrovaskulær lidelse og tidsmessig sammenheng med den kognitive svikten. Ujevn fordeling av den kognitive svikten og tegn til fokal hjernelidelse
Diagnostikk:
Utredning av vaskulær årsak til demenssyndromet er forutsetning for vurdering av sekundærprevensjon. MR eller CT cerebrum. EKG og blodprøver. Ev. tilleggsundersøkelser for å avdekke sekundære demensformer. Vurdering av blandingstilstand med Alzheimers demens 
Behandling:
Kontroll og ved behov behandling av kardiovaskulære risikofaktorer og -sykdommer (sekundærprofylakse). Organisering av støttetiltak. Ved blandet Alzheimers- og vaskulær demens gjelder samme terapianbefalinger som ved Alzheimers demens
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  • Peter D. Jost, spesialist i allmennmedisin, redaktør NEL

Tidligere fagmedarbeidere

  • Bjørnar Grenne, PhD, konst. overlege, Klinikk for hjertemedisin, St. Olavs Hospital, Trondheim
  • Ivar B. Mediås, spesialist i allmennmedisin, leder for NSAM referansegruppe i geriatri, Sørum legesenter, Sørumsand