What is the disorder characterized by thrombi that obstruct small and medium size vessels of the brain, commonly associated with long-term alcohol abuse?

Vascular dementia is characterized by cognitive decline resulting from impaired blood flow to the brain, often caused by thrombi that obstruct small and medium-sized vessels. In the context of individuals with long-term alcohol abuse, the risk of developing vascular dementia increases due to several factors, including hypertension, nutritional deficiencies, and direct neurotoxic effects of alcohol on the vascular system. These factors contribute to the formation of thrombi, leading to ischemic events that can damage cerebral tissue, ultimately affecting cognitive function.

In contrast, Alzheimer's dementia primarily involves the accumulation of amyloid plaques and neurofibrillary tangles, and its pathophysiology is not directly related to thrombotic events in the vessels of the brain. Lewy body dementia is associated with the presence of Lewy bodies in the brain and is characterized by fluctuating cognition, visual hallucinations, and parkinsonism rather than vascular causes. Substance-induced dementia refers to cognitive impairment resulting from the effects of substances, including drugs or alcohol, but in this case, does not specifically address the vascular complications caused by alcoholism. Thus, vascular dementia most accurately represents the scenario described, linking long-term alcohol abuse with the formation of thrombi and subsequent cognitive decline.