Vascular cognitive impairment
Encyclopedia
Vascular cognitive impairment (VCI) is a term used to describe a spectrum of cognitive impairments caused by various types of cerebrovascular disease that occurs as a result of interaction between a variety of vascular risk factors such as hypertension
, obesity
, dyslipidemia
, diabetes mellitus
, stroke
and silent stroke
. Included in this spectrum is Vascular Dementia
(VaD), (the second leading cause of dementia after Alzheimers disease (AD)) and Mild Vascular Cognitive Impairment (MVCI).
VCI may result from clinical stroke of the large vessels or from microangiopathic changes in the small cerebral vessels. Radiological findings might include abnormally bright spots on a T2 weighted MRI scan in periventricular regions or in the deep white matter. This so called "white matter disease" is commonly associated with vascular risk factors such as smoking and hypertension, and with subtle decline in cognitive performance with aging. Brain MRI might also show "lacunar infarcts" (spots which are hypointense on a T1 MRI scan) which are indicative of small "silent strokes", or hemorrhagic findings (small hemorrhagic findings are often referred to as "microbleeds"). The relative importance and precise aetiology of these findings remains a subject of debate.
Cognitive domains commonly affected by VCI include psychomotor processing speed, executive function and verbal memory.
Hypertension
Hypertension or high blood pressure is a cardiac chronic medical condition in which the systemic arterial blood pressure is elevated. What that means is that the heart is having to work harder than it should to pump the blood around the body. Blood pressure involves two measurements, systolic and...
, obesity
Obesity
Obesity is a medical condition in which excess body fat has accumulated to the extent that it may have an adverse effect on health, leading to reduced life expectancy and/or increased health problems...
, dyslipidemia
Dyslipidemia
Dyslipidemia or dyslipidaemia is an abnormal amount of lipids in the blood. In developed countries, most dyslipidemias are hyperlipidemias; that is, an elevation of lipids in the blood, often due to diet and lifestyle. The prolonged elevation of insulin levels can lead to dyslipidemia...
, diabetes mellitus
Diabetes mellitus
Diabetes mellitus, often simply referred to as diabetes, is a group of metabolic diseases in which a person has high blood sugar, either because the body does not produce enough insulin, or because cells do not respond to the insulin that is produced...
, stroke
Stroke
A stroke, previously known medically as a cerebrovascular accident , is the rapidly developing loss of brain function due to disturbance in the blood supply to the brain. This can be due to ischemia caused by blockage , or a hemorrhage...
and silent stroke
Silent stroke
A silent stroke is a stroke that does not have any outward symptoms, and the patient is typically unaware they have suffered a stroke. Despite not causing identifiable symptoms a silent stroke still causes damage to the brain, and places the patient at increased risk for both transient ischemic...
. Included in this spectrum is Vascular Dementia
Multi-infarct dementia
Multi-infarct dementia is one type of vascular dementia. Vascular dementia is the second most common form of dementia after Alzheimer's disease in older adults. Multi-infarct dementia is thought to be an irreversible form of dementia, and its onset is caused by a number of small strokes or...
(VaD), (the second leading cause of dementia after Alzheimers disease (AD)) and Mild Vascular Cognitive Impairment (MVCI).
VCI may result from clinical stroke of the large vessels or from microangiopathic changes in the small cerebral vessels. Radiological findings might include abnormally bright spots on a T2 weighted MRI scan in periventricular regions or in the deep white matter. This so called "white matter disease" is commonly associated with vascular risk factors such as smoking and hypertension, and with subtle decline in cognitive performance with aging. Brain MRI might also show "lacunar infarcts" (spots which are hypointense on a T1 MRI scan) which are indicative of small "silent strokes", or hemorrhagic findings (small hemorrhagic findings are often referred to as "microbleeds"). The relative importance and precise aetiology of these findings remains a subject of debate.
Cognitive domains commonly affected by VCI include psychomotor processing speed, executive function and verbal memory.
External links
- National Institute of Neurological Disorders and Stroke–Canadian Stroke Network Vascular Cognitive Impairment Harmonization Standards http://stroke.ahajournals.org/cgi/content/full/37/9/2220