[Vascular dementia: an update].

The concept of vascular dementia(VaD) has been under discussion for long time. The most widely used guideline is NINDS-AIREN. However, this guideline tends to emphasize memory impairment, which seems very unrealistic in some cases. Although several guidelines have been created in addition to NINDS-AIREN, each of these guidelines has its advantages and disadvantages. With respect to the pathophysiology, there have been recent important findings, particularly about subcortical vascular dementia(SVD). From the therapeutic point of view, there have been high expectations for cholinesterase inhibitors and memantine, but the effectiveness of these drugs has not proved impressive so far. In this manuscript, we summarized the concept of VaD. In addition, we described recent findings related to pathophysiology and medication by cholinesterase inhibitors and memantine.