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British Medical Bulletin Advance Access published online on August 4, 2007
British Medical Bulletin, doi:10.1093/bmb/ldm021
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© The Author 2007. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Modern concept of vascular cognitive impairment

J. V. Bowler

Department of Clinical Neurosciences, Royal Free & University College Medical School, Hampstead Campus, Rowland Hill St., London NW3 2PF, UK

Correspondence to: J.V. Bowler, Department of Clinical Neurosciences, Royal Free & University College Medical School, Hampstead Campus, Rowland Hill St., London NW3 2PF, UK E-mail: j.bowler{at}ucl.ac.uk

Background: Vascular cognitive impairment (VCI) has superseded vascular dementia and multi-infarct dementia as the concept to be used in cognitive decline due to cerebrovascular disease.

Method: The literature was reviewed with regard to the concept of VCI and its incidence, pathophysiological substrate, clinical features and management.

Results: A change in the diagnostic paradigm from the current Alzheimer-based definition of vascular dementia to VCI will allow the earlier identification of cases and will identify a different population from that recognized using the current criteria for vascular dementia.

Conclusions: Case identification at the earliest possible stage affords the greatest opportunity for treatment that may slow the rate of progression.

Keywords: vascular dementia • vascular cognitive impairment • dementia • leukoaraiosis • subcortical

Accepted for publication July 3, 2007.


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