International Psychogeriatrics
Volume 15, Supplement 1 - 2003

Neuropathology of Vascular Cognitive Impairment and Vascular Dementia
PAUL G. INCE AND MALEE S. FERNANDO

ABSTRACT. Understanding of vascular substrates of cognitive decline in the elderly is evolving to include a major emphasis on the impact of small vessel disease (SVD). While existing concepts of multi-infarct dementia and strategic infarct dementia remain valid, they present difficulty in generalizing clinicopathological correlations from patient to patient. The range and significance of lesions that should be included as manifestations of SVD are unresolved, as is their impact on, and association with, neurodegenerative changes. This mini-review summarizes the authors’ views on SVD substrates leading to cognitive decline and proposes priorities for pathological investigations of human cerebrovascular mechanisms leading to cognitive decline.

KEYWORDS: Vascular dementia; vascular cognitive impairment; cerebral infarcts; small vessel disease; white matter lesions