University of Southern California, Los Angeles, California, USA.
Johns Hopkins University, Baltimore, Maryland, USA.
Alzheimers Dement. 2020 Dec;16(12):1714-1733. doi: 10.1002/alz.12157. Epub 2020 Oct 8.
Vascular contributions to cognitive impairment and dementia (VCID) are characterized by the aging neurovascular unit being confronted with and failing to cope with biological insults due to systemic and cerebral vascular disease, proteinopathy including Alzheimer's biology, metabolic disease, or immune response, resulting in cognitive decline. This report summarizes the discussion and recommendations from a working group convened by the National Heart, Lung, and Blood Institute and the National Institute of Neurological Disorders and Stroke to evaluate the state of the field in VCID research, identify research priorities, and foster collaborations. As discussed in this report, advances in understanding the biological mechanisms of VCID across the wide spectrum of pathologies, chronic systemic comorbidities, and other risk factors may lead to potential prevention and new treatment strategies to decrease the burden of dementia. Better understanding of the social determinants of health that affect risks for both vascular disease and VCID could provide insight into strategies to reduce racial and ethnic disparities in VCID.
血管因素导致的认知障碍和痴呆(VCID)的特征是,衰老的神经血管单元面临并未能应对由于系统性和脑血管疾病、蛋白病(包括阿尔茨海默病生物学)、代谢疾病或免疫反应引起的生物损伤,导致认知能力下降。本报告总结了由美国国立心肺血液研究所和美国国立神经病学与卒中研究所召集的一个工作组的讨论和建议,该工作组旨在评估 VCID 研究领域的现状、确定研究重点并促进合作。正如本报告所述,在广泛的病理学、慢性系统性合并症和其他风险因素范围内,对 VCID 的生物学机制的理解的进展可能会导致潜在的预防和新的治疗策略,以降低痴呆的负担。更好地了解影响血管疾病和 VCID 风险的社会决定因素,可以为减少 VCID 中的种族和民族差异的策略提供深入的见解。