Vascular cognitive impairment and dementia (VCID) is the second most common cause of dementia after Alzheimer’s disease (AD), accounting for approximately 20% of cases. Small vessel disease (cSVD), particularly cerebral small vessel disease, is a key contributor to VCID, characterized by stenosis, ischemic lesions, and impaired cognitive functions like attention and executive control.

Aging, hypertension, diabetes, and smoking are critical risk factors for cSVD, which often presents clinically as white matter hyperintensities, lacunes, microbleeds, and brain atrophy, detectable through advanced neuroimaging. Key mechanisms underlying cSVD include chronic hypoperfusion, blood-brain barrier (BBB) dysfunction, impaired cerebrospinal fluid drainage, and vascular inflammation. While lifestyle interventions such as exercise and diet are promising strategies, pharmacological treatments targeting hypertension and atherosclerosis are also essential. As VCID and cSVD frequently coexist with AD, understanding the interplay between vascular and neurodegenerative pathologies will be essential in developing effective diagnostic tools and treatments for both conditions.

Reference: Inoue Y, Shue F, Bu G, Kanekiyo T. Pathophysiology and probable etiology of cerebral small vessel disease in vascular dementia and Alzheimer’s disease. Mol Neurodegener. 2023 Jul 11;18(1):46. doi: 10.1186/s13024-023-00640-5. PMID: 37434208; PMCID: PMC10334598.