Role of cerebrovascular disease in cognition

Abstract

Vascular risk factors and cerebrovascular disease are recognized factors implicated in the evolution towards dementia, not only of vascular origin, but also of degenerative dementia as Alzheimer’s disease. Even among nondemented subjects, hypertension, diabetes, and stroke are associated with worse performance in attention, speed and motor control, and executive functions. Influence of vascular risk factors in cognition starts early in life. Recently, several publications expressed that intervention in potential modifiable risk factors should receive special attention in order to delay or prevent dementia. Current scientific evidence sustains that policy actions should be conducted in order to reduce vascular risk factors in middle life, with population and community-level measures. Cerebral small vessel disease, which can be expressed by white matter changes, lacunes, and microbleeds, has gained clinical relevance in the last decades. Intervention in prevention of this previously overlooked disease can represent a potential outcome in experimental studies aiming to reduce cerebrovascular burden.