This article provides a diagnostic framework for vascular cognitive impairment, discusses prevalence and relationships to other neurodegenerative pathologies, and provides advice on diagnostic workup and management.
Vascular cognitive impairment is the second most common cause of cognitive impairment and frequently coexists with other neurodegenerative neuropathologies. Three new diagnostic criteria have been published recently; common diagnostic elements include the need to classify cognitive impairment as mild cognitive impairment or dementia and to link the cognitive impairment to evidence of clinically significant cerebrovascular disease. Vascular cognitive impairment may be further subclassified into poststroke vascular cognitive impairment and nonstroke vascular cognitive impairment, most commonly caused by cerebral small vessel disease, which may only be recognized on neuroimaging.
Vascular cognitive impairment is a potentially treatable common cause of cognitive impairment, progression of which may be slowed or halted by secondary prevention of vascular disease.
Address correspondence to Dr Eric Smith, University of Calgary, Room C1261, Foothills Medical Centre, 1403 29 St NW, Calgary, AB, Canada, Eesmith@ucalgary.ca.
Relationship Disclosure: Dr Smith serves as a board member of the Quality Oversight Committee of the American Heart Association and as an assistant editor for Stroke. Dr Smith receives grant support from the Alzheimer Society of Canada, the Canadian Institutes of Health Research, the Canadian Partnership Against Cancer, and the Heart and Stroke Foundation of Canada and receives research support from McMaster University.
Unlabeled Use of Product/Investigational Use Disclosure: Dr Smith discusses the unlabeled/investigational use of cholinesterase inhibitors for the treatment of vascular dementia.
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