Update on the Diagnosis and Management of Vascular Cognitive Impairment

Abstract

Introduction: The term vascular cognitive impairment refers to a clinical and etiological heterogeneous group of entities that may appear as a result of brain lesions caused by vascular disease. Aim: To update the evidence and recommendations on the diagnosis and management of vascular cognitive impairment. Results: vascular mild cognitive impairment and vascular dementia are entities that capture the entire spectrum of cognitive impairment following stroke or subclinical vascular brain injury. The recent update on the diagnostic criteria of these entities, with the incorporation of biomarkers and genetic tests for concomitant disorders such as Alzheimer’s disease, may lead to the development of new epidemiological and therapeutics studies. Different aspects should be considered in the management of these entities: control of vascular risk factors, inclusion in rehabilitation programs, secondary prevention and symptomatic pharmacological therapy. Donepezil can be useful for cognitive enhancement in patients with vascular dementia (Class IIa; Level of Evidence A) and Galantamine can be beneficial for patients with mixed Alzheimer’s disease/vascular dementia (Class IIa; Level of Evidence A). Conclusions: Early detection and accurate diagnosis and management of vascular cognitive impairment can benefit the quality of life of the affected patients. Prevention is still the best medical strategy in cerebrovascular disorders.