a) Alzheimer’s disease

Various actions are recommended to improve the accuracy of the diagnosis, such as the following:

1. Obtain a medical and family history of the individual, including a neuropsychiatric history and a history of changes in cognition and behaviour.
2. Review of medications used that could affect cognition
3. Ask family members and others close to you individually for changes in thinking or behaviour.
4. Cognitive tests, neurological exam, and physical tests.
5. Serological and neuroimaging tests (primarily to rule out other causes).

b) Vascular dementia

Patients at high risk for vascular cognitive impairment should be considered those who present the following risk factors: hypertension, age over 65, hyperlipidemia, diabetes mellitus, clinical evidence of cerebral vascular event, findings in neurodiagnostic images of cerebral vascular event and/or leukoencephalopathy, damage to other target organs (eye, kidney, heart), and patients with cognitive or functional changes that are clinically evident or reported during the completion of the clinical history.

General examinations are recommended in patients with suspected dementia, to exclude potentially reversible causes of dementia and for screening for comorbidities. As well as neuroimaging studies for the detection of vascular components.

It is recommended to differentiate between vascular dementia, Alzheimer’s disease or the co-existence of the two entities, using the Hachinski ischemia scale, in order to better identify treatment and prevention.