cess. There are no other established biomar kers of major or mild vascular NCD. 
Functional Consequences of 
Major or Mild Vascular Neurocognitive Disorder
Major or mild vascular NCD is commonly asso ciated with physical deficits that cause ad-
ditional disability. 
Differential Diagnosis 
Other neurocognitive disorders. Since incidental brain infarctions and white matter le-
sions are common in older individuals, it is important to consider other possible etiologies
when an NCD is present. A history of memory  deficit early in the course, and progressive
worsening of memory, language, executive function, and perceptual-motor abilities in the
absence of corresponding focal lesions on br ain imaging, are suggestive of Alzheimer’s
disease as the primary diagnosis. Potential bi omarkers currently being validated for Alz-
heimer’s disease, such as cerebrospinal fluid levels of beta-amyloid and phosphorylated
tau, and amyloid imaging, may prove to be helpful in the differential diagnosis. NCD with
Lewy bodies is distinguished fr om major or mild vascular NCD by its core features of fluc-
tuating cognition, visual hallu cinations, and spontaneous parkinsonism. While deficits in
executive function and language occur in majo r or mild vascular NC D, the insidious onset
and gradual progression of behavioral features or language impairment are characteristic
of frontotemporal NCD and are no t typical of vascular etiology.
Other medical conditions. A diagnosis of major or mild vascular NCD is not made if
other diseases (e.g., brain tumor, multiple sc lerosis, encephalitis, toxic or metabolic disor-
ders) are present and are of su fficient severity to account for the cognitive impairment.