Major or Mild Vascular Neurocognitive Disorder 621
Comorbidity 
Lewy body pathology frequent ly coexists with Alzheimer’s disease and cerebrovascular
disease pathology, particularly among the olde st age groups. In Alzheimer’s disease, there
is concomitant synuclein pathology in 60% of cases (if amygdala-restricted cases are in-
cluded). In general, there is a higher rate of Lewy body pathology in individuals with de-
mentia than in older individuals without dementia. 
Major or Mild Vascular Neurocognitive Disorder
Diagnostic Criteria  
A. The criteria are met for major or mild neurocognitive disorder.
B. The clinical features are consistent with a vascular etiology, as suggested by either of
the following: 
1. Onset of the cognitive deficits is temporally related to one or more cerebrovascular
events.
2. Evidence for decline is prominent in complex attention (including processing
speed) and frontal-executive function.
C. There is evidence of the presence of cere brovascular disease from history, physical
examination, and/or neuroimaging consider ed sufficient to account for the neurocog-
nitive deficits. 
D. The symptoms are not better explained by another brain disease or systemic disorder.
Probable vascular neurocognitive disorder  is diagnosed if one of the following is pres-
ent; otherwise possible vascular neurocognitive disorder  should be diagnosed:
1. Clinical criteria are supported by neuroimaging evidence of significant parenchymal in-
jury attributed to cerebrovascula r disease (neuroimaging-supported).
2. The neurocognitive syndrome is temporally related to one or more documented cere-
brovascular events.
3. Both clinical and genetic (e.g., cerebral aut osomal dominant arteriopathy with subcortical