Vascular Cognitive Impairment

The term vascular cognitive impairment (VCI) was introduced and designed to encompass the broad spectrum of neurocognitive deficits attributable to cerebrovascular disease, including cerebral infarctions and ischemia, that may involve the cerebral cortex, subcortical nuclei, and subcortical white matter, including lacunes (small infarcts that are 3 to 15 mm cerebrospinal fluid–filled cavities in the basal ganglia or white matter) leukoaraiosis (subcortical white matter), and other vascular-related lesions. The resulting impairment can vary, including the signs-symptoms, the clinical course, and disease severity. Whereas there is now agreement that cerebrovascular disease can be a major contributing factor underlying dementia, there is limited agreement about diagnostic criteria and clinical presentations. This chapter seeks to review pertinent literature on VCI as well as to investigate the construct of mild vascular cognitive impairment. This chapter will also briefly review the history of VCI, epidemiological research, neuropsychological signs and symptoms, and recent research regarding biomarkers, as well as public health and treatment issues.