NINDS-AIREN Criteria for Probable Vascular Dementia

 NINDS-AIREN Criteria for Probable Vascular Dementia

NINDS-AIREN Criteria for Probable Vascular Dementia


1. Dementia, defined by

                Cognitive decline from a previously higher level of functioning

                Impairment of memory and of two or more cognitive domains…

                Severe enough to interfere with activities of daily living and not due to                     physical effects of stroke alone.

  Exclusion criteria:

    Cases with disturbance of consciousness, delirium, psychosis, severe aphasia, or major sensorimotor impairment precluding neuropsychological testing.

    Also excluded are systemic disorders or other brain diseases (such as AD) that in and of themselves could account for deficits in memory and cognition.


2. Cerebrovascular disease (CVD), defined by

    Focal signs on neurological examination…consistent with stroke (with or without history of stroke)

    Evidence of relevant CVD by brain imaging (CT or MRI) including multiple large-vessel infarcts or a single strategically placed infarct…, as well as multiple basal ganglia and white matter lacunes or extensive periventricular white matter lesions or combinations.


3. A relationship between the above two disorders manifested or inferred by the presence of one or more of the following:

        Onset of dementia within three months following a recognized stroke

    Abrupt deterioration in cognitive functions, or fluctuating, stepwise

   progression of cognitive deficits

    Clinical features consistent with the diagnosis of probable vascular


        Early presence of a gait disturbance

        History of unsteadiness and frequent, unprovoked falls

        Early urinary symptoms not explained by urologic disease

        Pseudobulbar palsy

        Personality and mood changes, abulia, depression, emotional incontinence, or

       other subcortical deficits…



                                                  Adapted from NINDS-AIREN work group, Roman et al. 1993




 Clinical Classification of Vascular Dementia Syndromes



1. Multi-infarct dementia


2. Subcortical ischaemic dementia

             Lacunar state

        Diffuse leukoaraiosis ( Binswanger’s encephalopathy )


3. Strategic infarction

             Medial thalamic infarcts

             Lateral thalamic infarcts—internal capsular infarcts

             Caudate and pallidal infarction

             Posterior cerebral artery infarction

             Left angular gyrus (Gerstmann’s) syndrome

             Basal forebrain infarction