Vascular cognitive impairment

Abstract

The risk of cerebrovascular disease increases with advanced age, with almost two thirds of individuals over 70 exhibiting vascular lesions on MRI. Cognitive presentations vary from little or no no cognitive impairment to clinical dementia, and the extent of cognitive impairment is not necessarily correlated with lesion size or burden. The term vascular cognitive impairment (VCI) describes all forms of cognitive impairment caused by cerebrovascular disease. Early identification of vascular disease is critical since many risk factors are modifiable, and the neuropsychologist can play an important role in characterizing the extent of cognitive and behavioral change. This chapter provides an overview of the clinical guidelines to consider when evaluating older adults with possible VCI and includes an illustrative case example and useful recommendations for the clinician.