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BACKGROUND Vascular cognitive impairment (VCI) has superseded vascular dementia and multi-infarct dementia as the concept to be used in cognitive decline due to cerebrovascular disease.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