Factors that suggest vascular cognitive impairment and dementia (or Alzheimer disease with cerebrovascular disease) include the following: Imaging evidence of brain infarcts and other vascular brain damage Clinical features characteristic of vascular cognitive impairment and dementia (eg, prominent executive dysfunction, mild or absent memory loss) High Modified Hachinski Ischemic Score (if brain imaging is not available) Confirmation of vascular cognitive impairment and dementia requires a history of stroke or evidence of a vascular cause for dementia detected by neuroimaging.