skip to main content

Vascular Dementia – Hypertension Control — SCE Neurology MCQ

Instant feedback + full explanation. One question, done properly.

EasyNeurodegenerative DiseaseVascular Dementia – Hypertension ControlSCE Neurology

A 70-year-old man with vascular dementia has recurrent falls, urinary incontinence, and progressive gait apraxia. MRI brain shows extensive periventricular white matter hyperintensities, multiple lacunar infarcts, and prominent perivascular spaces. What vascular risk factor management is most important for preventing further cognitive decline?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — Aggressive management of vascular risk factors — particularly hypertension, which is the most important modifiable risk factor for small vessel disease and vascular cognitive impairment

Explanation lettering: D = shown as A · A = shown as B · E = shown as D · B = shown as E

Vascular cognitive impairment is caused predominantly by cerebral small vessel disease (SVD). Hypertension is the single most important modifiable risk factor for SVD. NICE NG97 recommends aggressive vascular risk factor management (BP control, diabetes management, cholesterol reduction, smoking cessation, exercise, diet, alcohol reduction) as the primary strategy for preventing progression of vascular cognitive impairment. There are no specific disease-modifying drugs for VaD. Cholinesterase inhibitors and memantine have modest evidence in mixed AD/VaD but are not recommended for pure VaD by NICE. A: Vascular risk factor management is evidence-based. C/D/E: All risk factors matter, but hypertension is the most important.

Reference: NICE NG97 Dementia; NICE NG136 Hypertension