Major or Mild Vascular Neurocognitive Disorders

Prevalence

  • Major or mild vascular NCD is the second most common cause of NCD after Alzheimer's disease.

  • Higher prevalence has been reported in African Americans compared with Caucasians, and in East Asian countries (e.g., Japan, China).

  • Prevalence is higher in males than in females.

Risk factors

Environmental

The neurocognitive outcomes of vascular brain injury are influenced by neuroplasticity factors such as education, physical exercise, and mental activity.

Genetic and physiological

The major risk factors are:

  • Hypertension.

  • Diabetes.

  • Smoking.

  • Obesity.

  • High cholesterol levels.

  • High homo cysteine levels.

  • Other risk factors for atherosclerosis and arteriosclerosis.

  • Atrial fibrillation, and other conditions increasing the risk of cerebral emboli.

  • Cerebral amyloid angiopathy is an important risk factor in which amyloid deposits occur within arterial vessels.

  • Hereditary condition cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy.

Symptoms

  • The criteria are met for major or mild neurocognitive disorder.

  • The clinical features are consistent with a vascular etiology, as suggested by either of the following:

    1. Onset of the cognitive deficits is temporally related to one or more cerebrovascular events.

    2. Evidence for decline is prominent in complex attention (including processing speed) and frontal-executive function.

  • There is evidence of the presence of cerebrovascular disease from history, physical examination, and/or neuroimaging considered sufficient to account for the neurocognitive deficits.

  • The symptoms are not better explained by another brain disease or systemic disorder.