Erkinjuntti Timo, Gauthier Serge
Front Neurol Neurosci. 2009;24:79-85. doi: 10.1159/000197886. Epub 2009 Jan 26.
Vascular cognitive impairment (VCI) is the modern term related to vascular burden of the brain,reflecting all encompassing effects of cerebrovascular disease (CVD) on cognition. VCI include all levels of cognitive decline from mild deficits in one or more cognitive domains to a broad dementia-like syndrome. VCI incorporates the complex interactions between vascular risk factors, CVD etiologies and cellular changes within the brain and cognition. Vascular risk factors towards VCI include,e.g. arterial hypertension, high cholesterol, and diabetes. VCI includes the common poststroke dementia and vascular dementia (VaD). The main subtypes of VaD include the cortical VaD or multi-infarct dementia also referred as poststroke VaD and subcortical ischemic vascular disease and dementia or small vessel dementia. Traditional vascular risk factors and stroke are also independent factors for the clinical presentation of Alzheimer's disease. In addition to these vascular factors, CVD/strokes, infarcts and white matter lesions may trigger and modify progression of Alzheimer's disease.Whilst CVD is preventable and treatable, it clearly is a major factor in the prevalence of cognitive impairment in the elderly worldwide.
血管性认知障碍(VCI)是与大脑血管负担相关的现代术语,反映了脑血管疾病(CVD)对认知的全面影响。VCI包括从一个或多个认知领域的轻度缺陷到广泛的痴呆样综合征等所有程度的认知衰退。VCI包含血管危险因素、CVD病因以及大脑内细胞变化与认知之间的复杂相互作用。导致VCI的血管危险因素包括,例如动脉高血压、高胆固醇和糖尿病。VCI包括常见的卒中后痴呆和血管性痴呆(VaD)。VaD的主要亚型包括皮质性VaD或多梗死性痴呆(也称为卒中后VaD)以及皮质下缺血性血管病和痴呆或小血管性痴呆。传统的血管危险因素和卒中也是阿尔茨海默病临床表现的独立因素。除了这些血管因素外,CVD/卒中、梗死和白质病变可能引发并改变阿尔茨海默病的进展。虽然CVD是可预防和可治疗的,但它显然是全球老年人认知障碍患病率的一个主要因素。