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A Mouse Model for Vascular Cognitive Impairment and Dementia Based on Needle-guided Asymmetric Bilateral Common Carotid Artery Stenosis
Published on: November 22, 2024
Vascular Cognitive Impairment and Dementia: JACC Scientific Expert Panel
Costantino Iadecola1, Marco Duering2, Vladimir Hachinski3
1Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, New York.
Insights
Vascular cognitive impairment and dementia (VCID) is a significant public health concern, particularly in East Asia. This review critically appraises VCID epidemiology, pathology, and treatment, highlighting research needs.
Area of Science:
- Neurology
- Public Health
- Gerontology
Background:
- Cognitive impairment in aging is a growing global challenge.
- While Alzheimer's disease is common in the West, vascular cognitive impairment and dementia (VCID) is the second leading cause and may be predominant in East Asia.
- Cerebral vascular changes, including microcirculation, significantly contribute to cognitive dysfunction, even in Alzheimer's disease.
Purpose of the Study:
- To provide a critical review of vascular cognitive impairment and dementia (VCID).
- To examine the epidemiology, pathobiology, neuropathology, and neuroimaging of VCID.
- To assess current diagnostic and therapeutic strategies and identify research gaps.
Main Methods:
- Expert panel review and critical appraisal of existing literature.
- Synthesis of data on epidemiology, pathobiology, neuropathology, and neuroimaging.
- Analysis of current diagnostic and therapeutic approaches.
Main Results:
- Vascular factors are crucial in cognitive impairment, irrespective of underlying pathology like Alzheimer's disease.
- VCID presents a significant challenge, with regional variations in prevalence (e.g., East Asia).
- Current understanding highlights the need for integrated approaches considering both vascular and other pathologies.
Conclusions:
- VCID is a major contributor to dementia, necessitating focused research and clinical attention.
- Further research into epidemiology, pathobiology, and neuroimaging is essential for improved diagnostics and therapeutics.
- Addressing unresolved issues in VCID research is critical for mitigating this devastating condition.
Abstract:
Cognitive impairment associated with aging has emerged as one of the major public health challenges of our time. Although Alzheimer's disease is the leading cause of clinically diagnosed dementia in Western countries, cognitive impairment of vascular etiology is the second most common cause and may be the predominant one in East Asia. Furthermore, alterations of the large and small cerebral vasculature, including those affecting the microcirculation of the subcortical white matter, are key contributors to the clinical expression of cognitive dysfunction caused by other pathologies, including Alzheimer's disease. This scientific expert panel provides a critical appraisal of the epidemiology, pathobiology, neuropathology, and neuroimaging of vascular cognitive impairment and dementia, and of current diagnostic and therapeutic approaches. Unresolved issues are also examined to shed light on new basic and clinical research avenues that may lead to mitigating one of the most devastating human conditions.
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