The concept of vascular cognitive impairment

Abstract

Vascular cognitive impairment (VCI) is the modern term related to vascular burden of the brain,reflecting all encompassing effects of cerebrovascular disease (CVD) on cognition. VCI include all levels of cognitive decline from mild deficits in one or more cognitive domains to a broad dementia-like syndrome. VCI incorporates the complex interactions between vascular risk factors, CVD etiologies and cellular changes within the brain and cognition. Vascular risk factors towards VCI include,e.g. arterial hypertension, high cholesterol, and diabetes. VCI includes the common poststroke dementia and vascular dementia (VaD). The main subtypes of VaD include the cortical VaD or multi-infarct dementia also referred as poststroke VaD and subcortical ischemic vascular disease and dementia or small vessel dementia. Traditional vascular risk factors and stroke are also independent factors for the clinical presentation of Alzheimer's disease. In addition to these vascular factors, CVD/strokes, infarcts and white matter lesions may trigger and modify progression of Alzheimer's disease.Whilst CVD is preventable and treatable, it clearly is a major factor in the prevalence of cognitive impairment in the elderly worldwide.