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World J Psychiatr. Jun 22, 2016; 6(2): 199-207
Published online Jun 22, 2016. doi: 10.5498/wjp.v6.i2.199
Vascular cognitive impairment, a cardiovascular complication
Adiukwu Frances, Ofori Sandra, Ugbomah Lucy
Adiukwu Frances, Ugbomah Lucy, Department of Neuropsychiatry, University of Port Harcourt Teaching Hospital, Port Harcourt PMB 6173, Rivers State, Nigeria
Ofori Sandra, Department of Internal Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt PMB 6173, Rivers State, Nigeria
Author contributions: Frances A did majority of the writing and prepared the tables; Sandra O provided the guidelines for writing the manuscript as well as provided scientific knowledge; Lucy U reviewed the language of the manuscript and provided scientific knowledge.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Adiukwu Frances, MBBS, Department of Neuropsychiatry, University of Port Harcourt Teaching Hospital, East-West Road, Port Harcourt PMB 6173, Rivers State, Nigeria. francesadiukwu@gmail.com
Telephone: +234-803-2649075
Received: October 16, 2015
Peer-review started: October 17, 2015
First decision: November 27, 2015
Revised: January 14, 2016
Accepted: February 14, 2016
Article in press: February 16, 2016
Published online: June 22, 2016
Processing time: 247 Days and 19.2 Hours
Abstract

Over the past two decades, the term vascular cognitive impairment (VCI) has been used to refer to a spectrum of cognitive decline characterized by executive dysfunction, associated with vascular pathology. With 30% of stroke survivors showing cognitive impairments, it is regarded as the most common cause of cognitive impairment. This is a narrative review of available literature citing sources from PubMed, MEDLINE and Google Scholar. VCI has a high prevalence both before and after a stroke and is associated with great economic and caregiver burden. Despite this, there is no standardized diagnostic criteria for VCI. Hypertension has been identified as a risk factor for VCI and causes changes in cerebral vessel structure and function predisposing to lacuna infarcts and small vessel haemorrhages in the frontostriatal loop leading to executive dysfunction and other cognitive impairments. Current trials have shown promising results in the use of antihypertensive medications in the management of VCI and prevention of disease progression to vascular dementia. Prevention of VCI is necessary in light of the looming dementia pandemic. All patients with cardiovascular risk factors would therefore benefit from cognitive screening with screening instruments sensitive to executive dysfunction as well as prompt and adequate control of hypertension.

Keywords: Vascular dementia; Leukoaraiosis; White matter hyperintensities; Cognitive screening; Neurodegeneration

Core tip: Vascular cognitive impairment (VCI) has recently been receiving more interest in the scientific world in terms of early identification, preventing as well as slowing down the rate of progression to vascular dementia. Majority of the risk factors for VCI are modifiable and thus amendable to treatment. This review aims to look at hypertension and its role in the early identification and prevention of VCI and dementia.