The Concept of Vascular Cognitive ImpairmentErkinjuntti T.a · Gauthier S.b
aMemory Research Unit, Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland; bMcGill Center for Studies in Aging, McGill University, Montréal, Que., Canada
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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 alllevels of cognitive decline from mild deficits in one or more cognitive domains to a broad dementialikesyndrome. VCI incorporates the complex interactions between vascular risk factors, CVD etiologiesand 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 poststrokedementia and vascular dementia (VaD). The main subtypes of VaD include the cortical VaD or multiinfarctdementia also referred as poststroke VaD and subcortical ischemic vascular disease anddementia or small vessel dementia. Traditional vascular risk factors and stroke are also independentfactors 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 cognitiveimpairment in the elderly worldwide.
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