Vascular Cognitive Impairment and Dementia: Clinical Features, Neuropathology, and Biomarkers.
Level 5 - mechanism / opinion, no new human data
Narrative review synthesizing clinical concepts and expert consensus without systematic review or meta-analysis methodology.
PubMed 41498479 · doi:10.1016/j.jacc.2025.11.008
What was done
This paper is Part 1 of a narrative review series aimed at cardiovascular clinicians, synthesizing current knowledge on the clinical features, pathophysiology, diagnostic criteria, and neuroimaging biomarkers of vascular cognitive impairment and dementia (VCID).
What was found
The abstract reports summary epidemiological estimates and diagnostic characteristics: VCID accounts for 15% to 20% of all dementia cases, with cerebrovascular disease contributing to neuropathology in up to 75% of cases. Common cardiovascular conditions (atrial fibrillation, heart failure, acute coronary syndrome, valvular disease) and shared risk factors (midlife hypertension, diabetes) elevate VCID risk. Diagnosis relies on a two-step approach identifying a cognitive syndrome (frequently characterized by executive dysfunction, slowed processing speed, and attention deficits) and confirming vascular etiology via neuroimaging markers such as infarcts, lacunes, white matter hyperintensities, dilated perivascular spaces, and microbleeds.
Why it matters
It highlights the strong intersection between cardiac disease and cognitive decline, outlining diagnostic and neuroimaging criteria to help cardiovascular specialists identify cerebrovascular disease and early cognitive impairment.
Limits
The abstract provides descriptive overview statistics without systematic review methodology, meta-analytic effect sizes, or primary clinical data. Quantitative diagnostic accuracy metrics (e.g., sensitivity or specificity of specific MRI biomarkers) are not reported.
Cited by
- supports Cerebral small vessel disease is the second most common form of dementia behind Alzheimer's disease.
- supports Small vessel disease causes lacunar infarcts that can be detected on MRI and lead to progressive cognitive decline.