Vascular cognitive impairment (VCI): Progress towards knowledge and treatment

Area of Science:

• Neurology
• Neuroscience
• Public Health

Background:

• Cognitive impairment as a manifestation of cerebrovascular disease (CVD) lacked standardized assessment methods.
• Vascular cognitive impairment (VCI) describes cognitive decline associated with CVD, encompassing mild deficits to dementia.
• VCI involves interactions between vascular risk factors, CVD subtypes, and Alzheimer's Disease pathology.

Purpose of the Study:

• To address the lack of common standards in assessing cognitive impairment in CVD.
• To integrate knowledge on pathophysiological mechanisms underlying VCI.
• To establish a foundation for developing diagnostic criteria for VCI.

Main Methods:

• Review of clinical, epidemiological, neuroimaging, and experimental data supporting the VCI concept.
• Identification of key pathophysiological mechanisms (excitotoxicity, apoptosis, oxidative stress, inflammation, etc.).
• Definition of data elements by NINDS and CSN in 2006 for future VCI studies.

Main Results:

• VCI is a prevalent and potentially preventable syndrome, often the earliest manifestation of CVD.
• Existing clinical trials lack standardized cognitive outcome measures for stroke patients.
• The impact of stroke treatments on cognitive outcomes remains largely unknown.

Conclusions:

• Standardized methodologies are essential for VCI research and the development of diagnostic criteria.
• Integrated knowledge on VCI's etiology, manifestations, and pathophysiology is needed.
• Further research integrating studies with agreed methodologies will accelerate understanding and treatment of VCI.