Vascular Cognitive Impairment and Dementia

"Vascular cognitive impairment and dementia (VCID), ie, cognitive impairment secondary to cerebrovascular disease (CeVD), is the second most common form of dementia after Alzheimer's disease (AD), accounting for 15% to 20% of all cases. CeVD, in fact, contributes to dementia alongside other neuropathologies in up to 75% of dementia cases."

"The diagnosis of VCID is a 2-step process, with the initial identification of a cognitive syndrome followed by the establishment of a predominantly vascular etiology, guided by clinical history and examination and substantiated by neuroimaging, preferably magnetic resonance imaging."

"Cognitive deficits can be found in several domains, such as information-processing speed, attention, executive function, and emotional lability, sometimes referred to as the subcortical syndrome, often seen in the early stages of VCID without cortical infarcts."

Vascular cognitive impairment and dementia (VCID) represents cognitive decline from cerebrovascular disease and is the second leading cause of dementia after Alzheimer's disease. VCID frequently coexists with Alzheimer's disease and shares common risk factors including midlife hypertension and diabetes. Cardiac disorders such as atrial fibrillation, heart failure, acute coronary syndrome, and valvular disease increase VCID risk. Diagnosis involves a two-step process: identifying cognitive syndrome followed by establishing vascular etiology through clinical evaluation and neuroimaging. Clinical presentations vary from acute onset to gradual progression depending on stroke patterns or cerebral small vessel disease. Cognitive deficits affect processing speed, attention, executive function, and emotional regulation. Magnetic resonance imaging confirms diagnosis by detecting infarcts, lacunes, white matter hyperintensities, perivascular spaces, and microbleeds.

Read at Medscape