Vascular Cognitive Impairment

Jonathan Graff-Radford, MD Dementia p. 147-164 February 2019, Vol.25, No.1 doi: 10.1212/CON.0000000000000684
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PURPOSE OF REVIEW: This article provides an overview of vascular cognitive impairment; discusses its epidemiology, subtypes, and associations with other neurodegenerative diseases; and reviews the diagnostic evaluation and management of these disorders.

RECENT FINDINGS: Cerebrovascular disease is a common cause of dementia and frequently coexists with neurodegenerative causes. The heterogeneity of mechanisms leading to vascular cognitive impairment makes developing unifying clinical and research criteria difficult. Recognizing the neuroimaging hallmarks of different forms of vascular cognitive impairment can allow for individualized treatment and management. In individuals with mild vascular cognitive impairment, aerobic exercise appears to be a promising treatment but requires further investigation.

SUMMARY: Vascular cognitive impairment can be caused by several mechanisms. While treating vascular risk factors is rational to prevent worsening of cognitive impairment, well-designed studies are needed to demonstrate efficacy.

Address correspondence to Dr Jonathan Graff-Radford, Department of Neurology, Mayo Clinic, 200 First St SW, Rochester, MN 55905,

RELATIONSHIP DISCLOSURE: Dr. Graff-Radford receives research/grant support from the National Institute on Aging/National Institutes of Health (K76AG057015).

UNLABELED USE OF PRODUCTS/INVESTIGATIONAL USE DISCLOSURE: Dr Graff-Radford discusses the unlabeled/investigational use of acetylcholinesterase inhibitors and memantine for vascular cognitive impairment.

© 2019 American Academy of Neurology