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Vascular Cognitive Disorder
Matt B Paradise1, Perminder S Sachdev1,2
1Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney, NSW, Australia.
Insights
Vascular cognitive disorder (VCD) involves cognitive impairment from cerebrovascular disease (CVD), impacting memory and thinking. Controlling vascular risk factors is key for prevention and treatment of VCD.
Area of Science:
- Neurology
- Neuroscience
- Geriatrics
Background:
- Vascular cognitive disorder (VCD) is a significant cause of cognitive impairment, second only to Alzheimer's disease.
- VCD encompasses a spectrum of cognitive deficits linked to cerebrovascular disease (CVD), including vascular dementia (VaD).
- Prevalence estimates for VCD vary due to differing diagnostic criteria, highlighting a need for standardization.
Purpose of the Study:
- To define vascular cognitive disorder (VCD) and its relationship with cerebrovascular disease (CVD).
- To review the range of neuropathological mechanisms underlying VCD.
- To emphasize the role of neuroimaging and vascular risk factor control in VCD management.
Main Methods:
- Review of existing literature on VCD and CVD.
- Analysis of neuropathological mechanisms and their interaction with other pathologies like Alzheimer's disease.
- Examination of recent neuroimaging findings and treatment strategies.
Main Results:
- VCD is a heterogeneous group of disorders characterized by cognitive impairment due to CVD.
- CVD interacts with other neuropathologies, such as Alzheimer's disease, contributing to mixed-pathology dementia.
- Neuroimaging advancements have enhanced understanding of VCD etiology.
Conclusions:
- Standardized diagnostic criteria for VCD are being developed.
- Symptomatic treatments for VaD offer modest benefits.
- Primary and secondary prevention through vascular risk factor control are crucial for managing VCD.
Abstract:
The term vascular cognitive disorder (VCD) refers to a heterogeneous group of disorders in which the primary feature is cognitive impairment attributable to cerebrovascular disease (CVD). This includes not only vascular dementia (VaD) but also cognitive impairment of insufficient severity to meet diagnostic criteria for dementia. VCD is recognized as the second most common cause of dementia after Alzheimer's disease (AD), but prevalence rates vary widely according to the diagnostic criteria employed. There have been recent attempts to standardize diagnostic criteria. VCD incorporates a range of neuropathological mechanisms including poststroke impairment, small and large vessel disease, and cases of mixed-pathology, with CVD interacting with AD and other neuropathologies. Recent neuroimaging data have improved our understanding of the etiology of VCD. Symptomatic treatments for VaD have modest benefit and there is increased focus on the primary and secondary preventative benefits of vascular risk factor control.
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