Vascular cognitive impairment
Abstract
The term vascular cognitive impairment (VCI) has been proposed to encompass all people with cognitive impairment of cerebrovascular origin. VCI is not a single condition, but has several clinical presentations, etiologies, and treatment. VCI forms a spectrum that includes vascular dementia, mixed Alzheimer's disease with a vascular component, and VCI that does not meet dementia criteria. Multiple pathophysiological mechanisms contribute to VCI, accounting for its heterogeneity. Although main changes in the brain in VCI include cerebral infarcts, vascular cognitive impairment is thought to be due to factors beyond acute infarcts. Cerebral white matter lesions and silent brain infarcts are considered to be risk factors for VCI. The prevalence of VCI is high and this entity is poised to become the silent epidemic of the 21st century. Cognitive impairment due to cerebrovascular disease can to some extent be improved, and VCI prevented, if vascular risk factors are brought under control and strokes do not recur. Therefore, strategies that focus on the prevention and treatment of the cognitive impairment associated with cerebrovascular disease are high priority healthcare objectives.
Keywords: Dementia; stroke; vascular cognitive impairment; vascular dementia; vascular risk factors.
Conflict of interest statement
References
-
- Hachinski VC, Bowler JV. Vascular dementia: diagnostic criteria for research studies. Neurology. 1993;43:2159–60. - PubMed
-
- Erkinjuntti T, Inzitari D, Pantoni L, Wallin A, Scheltens P, Rockwood K, et al. Research criteria for subcortical vascular dementia in clinical trials. J Neural Transm Suppl. 2000;59:23–30. - PubMed
-
- Pohjasvaara T, Erkinjuntti T, Vataja R, Kaste M. Dementia three months after stroke: baseline frequency and effect of different definitions of dementia in the Helsinki Stroke Aging Memory Study (SAM) cohort. Stroke. 1997;28:785–92. - PubMed
-
- Tatemichi TK, Desmond DW, Stern Y, et al. Prevalence of dementia after stroke depends on diagnostic criteria. Neurology. 1992;42:413.
-
- Knopman DS, Parisi JE, Boeve BF, Cha RH, Apaydin H, Salviati A, et al. Vascular dementia in a population-based autopsy study. Arch Neurol. 2003;60:569–75. - PubMed
LinkOut - more resources
Full Text Sources