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Nat Rev Dis Primers. 2018 Feb 15;4:18003. doi: 10.1038/nrdp.2018.3.

Vascular cognitive impairment.

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Alzheimer Center, Department of Neurology, Amsterdam Neuroscience, VU University Medical Center, de Boelelaan 1118, 1081 HZ Amsterdam, Netherlands.
Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, Netherlands.
Center for Ageing and Health, Institute for Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Departments of Pathology and Neurological Sciences, Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.
L. Sacco Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
Therese Pei Fong Chow Research Center for Prevention of Dementia, Lui Che Woo Institute of Innovative Medicine, Gerald Choa Neuroscience Center, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.
Departments of Pharmacology and Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Memory Aging and Cognition Centre, National University Health System, Singapore.


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.


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