Psychotherapy High Wycombe Psychotherapy High Wycombe - Last updated 07 January 2026

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DSM-IV: Vascular Dementia

When there is evidence that Dementia iscaused by cardiovascular disease this diagnosis may apply. Computed imaging studies of the brain, such as CT (computed tomography) and MRI (magnetic resonance imaging), can usually detect evidence of vascular lesions.

Diagnostic criteria for 290.4x Vascular Dementia

A. The development of multiple cognitive deficits manifested by both
(1) memory impairment (impaired ability to learn new information or to recall previously learned information)
(2) one (or more) of the following cognitive disturbances:
(a) aphasia (language disturbance)
(b) apraxia (impaired ability to carry out motor activities despite intact motor function)
(c) agnosia (failure to recognize or identify objects despite intact sensory function)
(d) disturbance in executive functioning (i.e., planning, organizing, sequencing, abstracting)

B. The cognitive deficits in Criteria A1 and A2 each cause significant impairment in social or occupational functioning and represent a significant decline from a previous level of functioning.

C. Focal neurological signs and symptoms(e.g. exaggeration of deep tendon reflexes, extensor plantar response, pseudobulbar palsy, gait abnormalities, weakness of an extremity) or laboratory evidence indicative of cerebrovascular disease (e.g. multiple infarctions involving cortex and underlying white matter) that are judged to be etiologically related to the disturbance.

D. The deficits do not occur exclusively during the course of a Delirium.

Code based on predominant features:

290.41 With Delirium: if delirium is superimposed on the dementia
290.42 With Delusions: if delusions are the predominant feature
290.43 With Depressed Mood: if depressed mood (including presentations that meet full symptom criteria for a Major Depressive Episode) is the predominant feature. A separate diagnosis of Mood Disorder Due to a General Medical Condition is not given.
290.40 Uncomplicated: if none of the above predominates in the current clinical presentation

Specify if: With Behavioral Disturbance
Coding note: Also code cerebrovascular condition on Axis III.

Based on the Diagnostic & Statistical Manual of Mental Disorders, 4th edition APA

Also: arteriosclerotic psychosis, multi-infarct dementia

The online Diagnostic & Statistical Manual of Mental Disorders lists most of the major psychological disorders and illnesses and lists the criteria that must be fulfilled in order for a diagnosis to be made. This resource is not a substitute for proper professional psychiatric diagnosis.