Related Experiment Video
Updated: Mar 8, 2026
Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Vascular Cognitive Impairment
Martin Dichgans1, Didier Leys2
1From the Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität LMU, Munich, Germany (M.D.); German Center for Neurodegenerative Diseases (DZNE), Munich, Germany (M.D.); Munich Cluster for Systems Neurology (SyNergy), Germany (M.D.); and University of Lille, INSERM, CHU Lille, U1171-Degenerative & Vascular Cognitive Disorders, F-59000 Lille, France (D.L.). martin.dichgans@med.uni-muenchen.de.
Insights
Cerebrovascular disease, including stroke, significantly impacts cognition, leading to vascular cognitive impairment. Managing vascular risk factors may help prevent cognitive decline and dementia.
Area of Science:
- Neurology
- Neuroscience
- Vascular Medicine
Background:
- Cerebrovascular disease commonly causes stroke and cognitive impairment.
- Vascular cognitive impairment (VCI) encompasses all cognitive disorders linked to cerebrovascular disease, ranging from mild deficits to dementia.
- VCI can result from various factors including microinfarcts, microhemorrhages, and white matter damage.
Purpose of the Study:
- To reappraise vascular cognitive impairment in light of recent scientific advances.
- To highlight the role of vascular brain injury in compromising brain connectivity and function.
- To discuss the coexistence of vascular and neurodegenerative pathologies in dementia.
Main Methods:
- Review of recent advances in neuroimaging, neuropathology, epidemiology, and genetics.
- Analysis of the mechanisms linking vascular brain injury to cognitive deficits.
- Examination of the prevalence and impact of VCI in stroke and non-stroke populations.
Main Results:
- Vascular brain injury disrupts structural and functional brain connectivity.
- Vascular dementia is the second leading cause of dementia, often mixed with Alzheimer's pathology.
- Targeting vascular risk factors shows potential for dementia prevention, including Alzheimer's type.
Conclusions:
- Vascular cognitive impairment is a significant consequence of cerebrovascular disease, affecting a broad spectrum of cognitive functions.
- Understanding the interplay between vascular and neurodegenerative processes is crucial for diagnosing and managing dementia.
- Preventive strategies targeting vascular health are essential for reducing the burden of cognitive impairment and dementia.
Abstract:
Cerebrovascular disease typically manifests with stroke, cognitive impairment, or both. Vascular cognitive impairment refers to all forms of cognitive disorder associated with cerebrovascular disease, regardless of the specific mechanisms involved. It encompasses the full range of cognitive deficits from mild cognitive impairment to dementia. In principle, any of the multiple causes of clinical stroke can cause vascular cognitive impairment. Recent work further highlights a role of microinfarcts, microhemorrhages, strategic white matter tracts, loss of microstructural tissue integrity, and secondary neurodegeneration. Vascular brain injury results in loss of structural and functional connectivity and, hence, compromise of functional networks within the brain. Vascular cognitive impairment is common both after stroke and in stroke-free individuals presenting to dementia clinics, and vascular pathology frequently coexists with neurodegenerative pathology, resulting in mixed forms of mild cognitive impairment or dementia. Vascular dementia is now recognized as the second most common form of dementia after Alzheimer's disease, and there is increasing awareness that targeting vascular risk may help to prevent dementia, even of the Alzheimer type. Recent advances in neuroimaging, neuropathology, epidemiology, and genetics have led to a deeper understanding of how vascular disease affects cognition. These new findings provide an opportunity for the present reappraisal of vascular cognitive impairment. We further briefly address current therapeutic concepts.
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