Is the distinction between Alzheimer's disease and vascular dementia possible and relevant?

Advances in epidemiological, clinical, imaging, and neuropathological studies have undermined the clear distinction between vascular and Alzheimer-type dementia, which has characterized the last two decades of research in dementia. A significant degree of overlap between the two entities was demonstrated in terms of clinical expression, risk factors, and postmortem brain autopsy. In this article, we propose mechanisms by which cardiovascular risk factors might affect the manifestation of Alzheimer's disease, suggest possible explanations for the overlap with vascular dementia, and discuss the implications this might have on future differential diagnosis and treatment strategies.