Abstract
Vascular cognitive impairment (VCI) is a term that denotes cognitive impairment linked to cerebrovascular disease. This concept had been originally advocated by Hanchinski et al. to introduce preventive treatment, and encompasses VCI-no dementia, vascular dementia, poststroke dementia, and mixed dementia ranging from prodromal to advanced stages. Diagnosis of vascular dementia at early stages is difficult because vascular burden to cognitive function varies depending on the spatial distribution, extent, and character of vascular lesions. Therefore, diagnostic criteria are dependent on the temporal relationship less than 3 months between stroke episodes and cognitive decline. However, only half cases exhibit stroke episodes in Binswanger’s disease with lacunar infarctions and extensive white matter lesions. Therefore, vascular dementia may not show temporal relationship with cerebrovascular disease, and moreover, those with Alzheimer’s disease have vascular burden at their middle ages. Taken together, the notion of VCI is useful at present for early therapeutic intervention, and in the future it is expected to understand the pathophysiology of mixed dementia and VCI with the advent of molecular imaging techniques for amyloid and tau proteins.
