Prevention of Vascular Cognitive Impairment

Stroke AHA Journals: August 30, 2012

Dementia has become a pressing health issue, with numbers steadily increasing. Vascular injury is the second most common cause of dementia after Alzheimer disease (AD) and a defining feature of vascular cognitive impairment (VCI), which encompasses the full range from vascular dementia (VaD) to mild cognitive impairment of vascular origin.^1,2

There are various manifestations of vascular brain injury, including silent or covert brain infarcts, white matter lesions, and clinically overt strokes, all of which may contribute to cognitive decline. Cerebral small vessel disease has been recognized as the most common etiology of VCI, but there are multiple vascular causes and mechanisms that share major risk factors and may run in parallel. Adding to this complexity, vascular pathology frequently coincides with neurodegenerative pathology and disentangling the contribution of individual pathologies to cognitive decline is notoriously difficult even with advanced diagnostic tools. Read More