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Subcortical vascular cognitive impairment – the pathology and pathophysiology

Part of: Bespoke shallow archive Weizmann

Published online by Cambridge University Press:  01 February 2007

J Birns  and
L Kalra
J Birns*
Affiliation:
King's College London School of Medicine, LondonUK
L Kalra
Affiliation:
King's College London School of Medicine, LondonUK
*
Address for correspondence: J Birns, Deptartment of Stroke Medicine, King's College London School of Medicine, Denmark Hill Campus, Bessemer Road, London SE5 9PJ, UK.
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Extract

Vascular cognitive impairment (V.C.I.) encompasses all forms of cognitive loss associated with cerebrovascular disease and ischaemic brain injury. It includes cognitive impairment related to stroke, cortical and subcortical infarcts, silent infarcts and strategic infarcts, white matter lesions associated with small vessel disease, and specific arteriopathies such as CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leucoencephalopathy). Recent studies have demonstrated that VCI is most commonly of a subcortical aetiology with small vessel disease being the major cause. VCI plays an important part in patients with other forms of dementia, such as Alzheimer's disease, who have coexisting vascular lesions and it has been proposed that VCI may be the most common form of cognitive impairment in older people, with a prevalence of 5% in people over the age of 65. In view of the aging population and the growing magnitude of vascular disease in western society, the prevalence of subcortical VCI is likely to increase, with a greater impact on patients and health care providers. In this article, we will review the cerebrovascular pathology underlying subcortical VCI and its role in mediating the characteristic cognitive deficits.

Type
Clinical geriatrics
Information
Reviews in Clinical Gerontology , Volume 17 , Issue 1 , February 2007 , pp. 39 - 44
Copyright
Copyright © Cambridge University Press 2008

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