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Vascular dementia — DGM MCQ

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HardDementiaVascular dementiaDGM

An 83-year-old woman has stepwise cognitive decline after two episodes of right-sided weakness. She has hypertension, diabetes and atrial fibrillation. CT head shows multiple lacunar infarcts and periventricular small-vessel disease. What is the most likely diagnosis?

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Correct answer: E — Vascular dementia

Stepwise decline after cerebrovascular events with supportive imaging is most consistent with vascular dementia. Alzheimer's disease can coexist, but the temporal relationship to strokes and vascular burden makes vascular dementia the best answer. Risk-factor optimisation remains part of dementia management.

Reference: NICE NG97