Modern concept of vascular cognitive impairment.

BACKGROUND: Vascular cognitive impairment (VCI) has superseded vascular dementia and multi-infarct dementia as the concept to be used in cognitive decline due to cerebrovascular disease.

METHOD: The literature was reviewed with regard to the concept of VCI and its incidence, pathophysiological substrate, clinical features and management.

RESULTS: A change in the diagnostic paradigm from the current Alzheimer-based definition of vascular dementia to VCI will allow the earlier identification of cases and will identify a different population from that recognized using the current criteria for vascular dementia.

CONCLUSIONS: Case identification at the earliest possible stage affords the greatest opportunity for treatment that may slow the rate of progression.