What is Vascular Cognitive Impairment?

Vascular cognitive impairment is a form of cognitive impairment associated with an underlying cerebrovascular disease. Researchers at the National Institute of Neurological Disorders and Stroke estimate than one in three people can expect to experience stroke or dementia, and sometimes both, in their lifetime, and vascular cognitive impairment is often involved. Research on cerebrovascular disease is a field of much interest for many people interested in aging and cognition, especially as human lifespans increase and expose people to the increased risk of stroke and other diseases of aging.

Patients with vascular cognitive impairment can experience a variety of symptoms. Memory loss may occur, along with difficulty completing cognitive tasks, trouble with language, and other issues like mood and behavioral changes. The area of the brain involved can vary, and as a result, the symptoms may be very broad. Some patients simply become forgetful as they age, while others may experience extreme personality changes and begin acting out aggressively or engaging in other undesirable behaviors.

A common cause of vascular cognitive impairment is high blood pressure, associated with damage to the blood vessels throughout the body. Patients can also experience stroke, in either ischemic or hemorrhagic forms. Ischemic strokes cause damage to the brain by temporarily cutting off blood supply, leading to cell death and subsequent cognitive impairments. In a hemorrhagic stroke, a rupture of a vessel in the brain leads to bleeding, causing increased pressure in the skull and killing brain cells.

Vascular malformations in the brain, including congenital malformations, as well as vascular tumors, can also be causes of vascular cognitive impairment. These malformations may put pressure on key areas of the brain, inhibiting brain activity. They can also rupture, causing stroke. Surgery to treat them comes with risks including additional cognitive impairments caused by working in the confined and delicate structures of the brain, where it is easy to accidentally damage parts of the brain during surgery.

As people age, they are usually asked to undergo regular medical evaluations to check for signs of common diseases of aging, from osteoporosis to vascular cognitive impairment. When identified early, more treatment options may be available, although any damage identified during screening may not be reversible. Younger people can also develop these conditions, and people at risk may be advised to get screened before they reach the usual age of onset. Risk factors for vascular cognitive impairment can include smoking, diabetes, chronic high blood pressure, and bleeding disorders.