Vascular cognitive impairment – definition and terms

Abstract

Vascular cognitive impairment (VCI) incorporates the complex interactions between vascular etiologies, risk factors and cellular changes within the brain and cognition. It includes the patients with vascular disease sufficient to cause a dementia syndrome . It may includes cases with cognitive impairment related to hypertension, silent infarcts, strategic infarcts, diabetes or atherosclerosis. The spectrum of brain changes comprise both ischemic factors and cellular processes such as demyelination, axonal damage, diastasis and atrophy. The studies suggest the association between vascular factors predisposing to cerebrovascular diseases and Alzheimer disease (AD). The hypertension, atrial fibrillation, carotid thickening and diabetes can increase the relative risk for Alzheimer disease. Studies of computed tomography (CT) and magnetic resonance imaging (MRI) showed that bilateral as opposed to unilateral ischemic lesions are critical. They showed the importance of deep infarcts in the frontal and limbic areas. Other studies indicated that the cortical lesions in the parietal and temporal areas are more important. Focal clinical signs, neuroimaging and neuropsychological findings may be reliably used to predict the neuropathologic diagnosis of vascular dementia (VaD). (1)

Keywords

• vascular cognitive impairment
• cerebrovascular disease
• vascular dementia