Vascular cognitive impairment, a cardiovascular complication

Abstract

Over the past two decades, the term vascular cognitive impairment (VCI) has been used to refer to a spectrum of cognitive decline characterized by executive dysfun-ction, associated with vascular pathology. With 30% of stroke survivors showing cognitive impairments, it is regarded as the most common cause of cognitive impairment. This is a narrative review of available litera-ture citing sources from PubMed, MEDLINE and Google Scholar. VCI has a high prevalence both before and after a stroke and is associated with great economic and caregiver burden. Despite this, there is no standardized diagnostic criteria for VCI. Hypertension has been identified as a risk factor for VCI and causes changes in cerebral vessel structure and function predisposing to lacuna infarcts and small vessel haemorrhages in the frontostriatal loop leading to executive dysfunction and other cognitive impairments. Current trials have shown promising results in the use of antihypertensive medi-cations in the management of VCI and prevention of disease progression to vascular dementia. Prevention of VCI is necessary in light of the looming dementia pandemic. All patients with cardiovascular risk factors would therefore benefit from cognitive screening with screening instruments sensitive to executive dysfunction as well as prompt and adequate control of hypertension. Core tip: Vascular cognitive impairment (VCI) has recently been receiving more interest in the scientific world in terms of early identification, preventing as well as slowing down the rate of progression to vas-cular dementia. Majority of the risk factors for VCI are modifiable and thus amendable to treatment. This review aims to look at hypertension and its role in the early identification and prevention of VCI and dementia. MINIREVIEWS 199 June 22, 2016|Volume 6|Issue 2| WJP|www.wjgnet.com