Pathology

Neuroscience

Vascular disease

Vascular dementia

Disease

Dementia

Cognitive decline

Diabetes mellitus

Endocrinology

Psychiatry

Cognition

Psychology

Cognitive impairment

Medicine

Nature Reviews Disease Primers

The term vascular cognitive impairment (VCI) was introduced around the start of the new millennium and refers to the contribution of vascular pathology to any severity of cognitive impairment, ranging from subjective cognitive decline and mild cognitive impairment to dementia. Although vascular pathology is common in elderly individuals with cognitive decline, pure vascular dementia (that is, dementia caused solely by vascular pathology) is uncommon. Indeed, most patients with vascular dementia also have other types of pathology, the most common of which is Alzheimer disease (specifically, the diffuse accumulation of amyloid-β plaques and neurofibrillary tangles composed of tau). At present, the main treatment for VCI is prevention by treating vascular diseases and other risk factors for VCI, such as hypertension and diabetes mellitus. Despite the current paucity of disease-modifying pharmacological treatments, we foresee that eventually, we might be able to target specific brain diseases to prevent cognitive decline and dementia. Vascular cognitive impairment (VCI) refers to any degree of cognitive impairment (from mild cognitive impairment to dementia) that is associated with vascular pathology. This Primer by van der Flier et al. describes the epidemiology, mechanisms, diagnosis and management of VCI.

Vascular cognitive impairment