Vascular Cognitive Impairment: Perspective and Review

Mild Cognitive Impairment (MCI) is a construct that has received considerable interest in the last 15 years. One variant of MCI is Vascular Cognitive Impairment (VCI), a relatively new idea with considerable importance. VCI is a reflection of cerebral vascular disease and is a prodrome of Vascular dementia. It is both prevalent and represents a marker that can be addressed and even prevented. Its presence suggests further decline, as well as current problems. In this article we address this heterogeneous condition and present a context. We discuss both Alzheimer's disease and vascular dementia, and consider the many variables related to vascular problems. We then consider MCI itself, with a focus on the relatively unstudied concept of mild vascular cognitive impairment. We address the cognitive features of this disease process and its implications for adjustment and potential problems. To illustrate these concepts, we will present a case, ways to assess it, and implications for treatment. We conclude by considering assessment and the issue of competence specific to VCI.