Vascular cognitive impairment: current approaches to diagnosis, treatment and prevention

Vascular cognitive impairment (VCI) is the second leading cause of dementia and associated disability, after Alzheimer’s disease. The new international diagnostic criteria for VCI, VasCog-2-WSO, are discussed. Synchronization of clinical data with neuroimaging criteria of cerebral small vessel disease is an important step in the integration and synthesis of knowledge about chronic cerebrovascular disease. VCI is the leading clinical manifestation of chronic cerebrovascular disease, whilst and hypertensive cerebral small vessel disease is its main substrate. The high clinical and neuroimaging significance of VCI, as reflected in the VasCog-2-WSO criteria, brings them closer to the domestic concept of dyscirculatory encephalopathy. Despite the lack of pathogenetic treatments, stroke prevention measures are highly effective in preventing the development and progression of VCI: giving up smoking and avoiding alcohol abuse, regular physical activity, a healthy diet and achieving a healthy body weight. Cognitive approaches and multi-component lifestyle interventions hold great potential. In patients with mild VCI, antihypertensive and lipid-lowering therapy, as well as a course administration of citicoline (Ceraxon), have high neuroprotective potential.