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Vascular cognitive impairment.

John T O'Brien1, Timo Erkinjuntti, Barry Reisberg

  • 1Institute for Aging and Health, Newcastle General Hospital, Newcastle upon Tyne, UK. j.t.obrien@ncl.ac.uk <j.t.obrien@ncl.ac.uk>

The Lancet. Neurology
|July 10, 2003
PubMed
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Cerebrovascular disease significantly impacts cognitive function, contributing to various dementias. Broadening definitions to include vascular cognitive impairment is crucial for accurate diagnosis and treatment.

Area of Science:

  • Neurology
  • Neuroscience
  • Geriatrics

Background:

  • Cerebrovascular disease is a leading cause of acquired cognitive impairment and dementia.
  • It plays a significant role in cognitive decline associated with neurodegenerative diseases.
  • Current definitions of vascular dementia are too narrow.

Purpose of the Study:

  • To review the scientific knowledge on vascular brain burden.
  • To advocate for broadening the definition of vascular dementia.
  • To propose the term vascular cognitive impairment (VCI).

Main Methods:

  • Literature review of scientific knowledge on vascular brain burden.
  • Analysis of the role of cerebrovascular disease in various cognitive disorders.
  • Examination of proposed diagnostic criteria for VCI subtypes.

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Main Results:

  • Cerebrovascular disease contributes to a spectrum of cognitive disorders, including hereditary vascular dementias, multi-infarct dementia, post-stroke dementia, and subcortical ischemic vascular disease.
  • Non-cognitive features like depression, apathy, and psychosis are important.
  • Vascular cognitive impairment presents a distinct profile: preserved memory with executive and attentional deficits.
  • Diagnostic criteria for VCI subtypes exist but require validation and refinement.

Conclusions:

  • The term vascular cognitive impairment should be adopted to encompass the cognitive effects of cerebrovascular disease.
  • Further validation and refinement of diagnostic criteria for VCI are urgently needed.
  • Early clinical trials suggest symptomatic treatments for VCI are beneficial.