Vascular Dementia and Cognitive Impairment

The increasing incidences of cognitive impairment and dementia are urgent public health issues, and cerebrovascular disease is emerging as a major contributor and attractive modifiable target for intervention. Vascular mild cognitive impairment (VaMCI) is a more recently recognized entity that includes mild cognitive deficits, while vascular dementia (VaD), as conventionally defined, is one of the most frequent forms of dementia. Further, when vascular contributions to other types of dementias are included, it is arguably the most common form of dementia. There are multiple neuroimaging methods to detect various markers of cerebrovascular disease, such as white matter lesions, perivascular spaces, and subclinical brain infarcts, all of which have been associated with worse cognitive function and decline. Emerging neuroimaging markers (e.g., blood-brain barrier integrity) and serum-or fluid-based biomarkers may help clinicians and researchers detect cerebrovascular disease-related cognitive dysfunction earlier in the disease course. Controlling cardiometabolic risk factors may help mitigate incidence of cerebrovascular disease and, in turn, reduce the risk of VaMCI and VaD. Future research is needed to identify the most salient targets for intervention.