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KMID : 1100220050040020063
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Dementia and Neurocognitive Disorders
2005 Volume.4 No. 2 p.63 ~ p.67
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New Treatment of Vascular Cognitive Impairment
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Lee Ae-Young
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Abstract
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Patients with vascular cognitive impairment (VCI) have cognitive decline associated with underlying cerebrovascular disease (CVD). The concept of VCI has been broadened to refer all forms of mild to severe cognitive impairment caused by CVD. Characteristic neuropsychological profile of VCI, particularly subcortical ischemic vascular dementia, includes early and prominent disturbance of attention and executive function with less severe episodic memory impairment. Evidence from neuropsychological studies of VCI shows that cognitive profile in VCI is associated with disruption of frontosubcortical circuits by lacunes and white matter lesions which are frequently located in frontal subcortical areas. Early recognition of VCI before the progression to vascular dementia is the main goal of clinical interest. Primary and secondary prevention of stroke can decrease the incidence and prevalence of VCI. Treatment with cholinesterase inhibitors showed modest symptomatic improvement in cognitive and non-cognitive abilities in patients with vascular dementia. But patients with VCI are too heterogeneous to evaluate the clinical efficacy of therapeutic trials. Selectivity on specific type of VCI seems to be better for defining treatment effectiveness in the field of VCI.
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KEYWORD
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Vascular dementia, Cerebrovascular disease, Treatment
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