VASCULAR COGNITIVE IMPAIRMENT

Abstract

Vascular cognitive impairment (VCI) is the second most common cause of dementia in patients older than 65. Dementia is a disease with major implications in society given high costs of health care and burden for the families as primary caregivers. VCI can manifest in a wide variety of symptoms depending on the localization of the brain damage and the size and number of lesions, as well as the presence of comorbid conditions that can affect cognition including depression and Alzheimer's disease. Prevention and aggressive treatment of vascular and metabolic risk factors starting early in life have been proposed as major factors in the prevention of cerebral vascular injury later in life and the development of VCI. Major diagnostic modalities include a thorough clinical evaluation that shows cognitive impairment and neuroimaging that demonstrates cerebral vascular damage based on structural MRI as the most sensitive and specific measure of vascular brain injury. To date, the FDA has not approved any therapies for the treatment of VCI. Cholinesterase inhibitors and memantine have shown some mild improvement in cognition but not in global endpoints.