Vascular Cognitive Impairment

Abstract

Cognitive impairment of vascular cause, henceforth referred to as Vascular Cognitive Impairment (VCI), refers to any type of cognitive or behavioral impairment that results from cerebrovascular disease, regardless of its severity and impact on the person’s functionality. Vascular Cognitive Impairment, as a broad concept, encompasses associations of other etiologies, including mixed etiologies. In its most severe form - Vascular Dementia (VaD), it implies a significant loss of function and behaves as a degenerative pathology which is therefore progressive. Vascular dementia is the second most common cause of dementia (after Alzheimer’s disease), but its prevalence is uncertain. Although cognitive impairment caused exclusively by vascular pathology is uncommon, vascular pathology is often associated with other degenerative pathologies, especially with advancing age. Cognitive impairment resulting from the vascular component is often underdiagnosed, especially in its mild stage, as it is typically characterized by alterations in executive functioning, attention, processing speed, and less memory alterations. As it is a potentially preventable clinical entity, there is an urgent need to promote better knowledge of the disease and its identification. Cognitive assessment should be targeted at the defects mentioned, as the screening measures and global cognitive assessment commonly used (designed mainly with Alzheimer’s disease in mind) may not be enough to detect them. Structural imaging tests are essential for diagnosis. There are no other biomarkers (apart from imaging) that can identify VCI in any of its stages, whether mild or more advanced. There are no approved therapies for the condition, and intervention should be aimed at vascular prevention and promoting better vascular health of the brain and better protection against injury.