Introduction: In a tropical environment, diagnostic certainty of vascular dementia is difficult to establish due to under-medicalization, consultation delays and especially the inadequacy of exploration methods.

Material and methods: We analyzed the files of 153 patients hospitalized for dementia syndrome over a period from January 1, 2016 to December 21, 2021 in the Neurology Department of the Hospital Center. University of Conakry. Dementia status was assessed according to the Clinical Rating Scale (CDS), confirmed by cognitive tests of the Mini-Mental State Examination (MMSE <24) or by the Mental State Examination score. Neurobehavioral cognitive state (NCSE).

Results: 26 (twenty-six) patients met the DSM-IV criteria for vascular dementia, based on the association of dementia and cerebrovascular disease certified by the presence of focal neurological signs of vascular origin and imaging data. Conclusion: this study shows a non-stereotyped clinical and etiological profile of the spectrum of vascular dementias in the tropics, in a context of under-medicalization. These results are useful for diagnostic and prognostic discussion.