4.5 Review

Vascular cognitive impairment

Journal

CURRENT OPINION IN NEUROLOGY
Volume 26, Issue 1, Pages 29-36

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/WCO.0b013e32835c4f04

Keywords

Alzhemier's disease; dementia; mild cognitive impairment; stroke

Funding

  1. American Heart Association [12CRP12050342]
  2. National Institutes of Neurological Disorders and Stroke [K02 NS 059729]
  3. National Heart Lung and Blood [R01 HL 108623]

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Purpose of review Clinically apparent and subclinical forms of vascular disease including stroke are important causes of cognitive dysfunction. In this review, we will describe the current nomenclature for vascular cognitive impairment (VCI) from the histopathological and clinical perspectives to raise awareness among practitioners about the interaction between conventional and novel vascular risk factors and VCI, with an emphasis on the prevention and risk factor modification. Recent findings There is substantial evidence from observational studies and clinical trials that conventional risk factors such as hypertension, diabetes, dyslipidemia, smoking, and atrial fibrillation play a role in the development of VCI. Additional novel risk factors such as the metabolic syndrome have been associated with cognitive dysfunction as well. Targeting these risk factors will minimize the burden of VCI in our aging population. Summary The concept of VCI has evolved to describe a continuum of cognitive disorders in which vascular brain injury plays a role, ranging from mild cognitive impairment to dementia. Future research is needed to clarify the role of risk factor modification in limiting vascular brain injury to prevent VCI and progression to dementia.

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