Vascular Cognitive Impairment and Vascular Dementia: A Literature Review
DOI:
10.29303/jbt.v26i3.12784Published:
2026-08-13Downloads
Abstract
Vascular Cognitive Impairment and Dementia (VCID) is a spectrum of cognitive disorders associated with cerebrovascular disease and is a major cause of cognitive decline and dementia in older adults. This study aimed to review the etiology, risk factors, pathophysiology, diagnostic evaluation, and management of VCID to support early detection and appropriate intervention. A literature review was conducted using relevant scientific publications and clinical guidelines addressing VCID. The findings indicate that VCID develops through complex mechanisms involving chronic cerebral hypoperfusion, blood–brain barrier dysfunction, vascular inflammation, impaired brain fluid drainage, and neuronal injury. Major risk factors include advanced age, hypertension, diabetes mellitus, dyslipidemia, smoking, atrial fibrillation, and cardiovascular disease, which contribute to cerebrovascular damage and cognitive impairment. Diagnosis requires comprehensive cognitive assessment, particularly the Montreal Cognitive Assessment (MoCA), supported by magnetic resonance imaging (MRI) to identify vascular lesions and exclude other causes of cognitive decline. Management requires an integrated, multimodal approach involving vascular risk-factor control, appropriate pharmacological therapy, cognitive rehabilitation, physical activity, and family and caregiver support. In conclusion, VCID is a multifactorial disorder with substantial clinical and socioeconomic consequences. Early cognitive screening, optimal management of vascular risk factors, rehabilitation, and increased public awareness are essential to facilitate prevention, early diagnosis, and long-term care while slowing disease progression and improving quality of life.
Keywords:
cerebrovascular Disease Cognitive Decline VCID Vascular Risk FactorsReferences
Brookes, R. L., Hollocks, M. J., Tan, R. Y. Y., Morris, R. G., & Markus, H. S. (2016). Brief screening of vascular cognitive impairment in patients with cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy without dementia. Stroke, 47(11), 2732–2738. https://doi.org/10.1161/STROKEAHA.116.013761
Clancy, U., Kancheva, A. K., Valdés Hernández, M. C., Jochems, A. C. C., Muñoz Maniega, S., Quinn, T. J., & Wardlaw, J. M. (2024). Imaging biomarkers of vascular cognitive impairment: A focused update. Stroke, 55(4), 1084–1094. https://doi.org/10.1161/STROKEAHA.123.044171
Dao, E., Barha, C. K., Zou, J., Wei, N., & Liu-Ambrose, T. (2024). Prevention of vascular contributions to cognitive impairment and dementia: The role of physical activity and exercise. Stroke, 55(4), 812–821. https://doi.org/10.1161/STROKEAHA.123.044173
Folloso, M. C. F., et al. (2024). The AHA/ASA and DSM-5 diagnostic criteria for vascular cognitive impairment identify cases with predominant vascular pathology. International Journal of Stroke. Advance online publication. https://doi.org/10.1177/17474930241252556
Gorelick, P. B., Scuteri, A., Black, S. E., Decarli, C., Greenberg, S. M., Iadecola, C., ... & American Heart Association Stroke Council. (2017). Vascular contributions to cognitive impairment and dementia: A statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 48(2), e1–e44.
Huang, W., Liao, L., Liu, Q., Ma, R., He, X., Du, X., & Sha, D. (2025). Blood biomarkers for vascular cognitive impairment based on neuronal function: A systematic review and meta-analysis. Frontiers in Neurology, 16, 1496711. https://doi.org/10.3389/fneur.2025.1496711
Iadecola, C., et al. (2016). Vascular cognitive impairment. Circulation Research, 118(11), 1832–1851. https://doi.org/10.1161/CIRCRESAHA.116.308426
Iluț, S., et al. (2023). Biological risk factors influencing vascular cognitive impairment. Biomedicines, 11, Article 1934. https://doi.org/10.3390/biomedicines11071934
Inoue, Y., Shue, F., Bu, G., & Kanekiyo, T. (2023). Pathophysiology and probable etiology of cerebral small vessel disease in vascular dementia and Alzheimer's disease. Molecular Neurodegeneration, 18, 46. https://doi.org/10.1186/s13024-023-00640-5
Jiménez-Ruiz, A., Aguilar-Fuentes, V., Becerra-Aguiar, N. N., Roque-Sanchez, I., & Ruiz-Sandoval, J. L. (2024). VCID: A narrative review. Dementia & Neuropsychologia, 18, e20230116. https://doi.org/10.1590/1980-5764-DN-2023-0116
Kementerian Kesehatan Republik Indonesia. (2023). Mengenal demensia Alzheimer. https://keslan.kemkes.go.id/view_artikel/2819/mengenal-demensia-alzheimer
Lennon, M. J., & Sachdev, P. S. (2026). VCID: Prevention, treatments, mechanisms and management options for the future. Neuropsychopharmacology. Advance online publication. https://doi.org/10.1038/s41386-026-02331-3
Livingston, G., Huntley, J., Liu, K. Y., Ames, D., Ballard, C., Banerjee, S., ... & Mukadam, N. (2024). Dementia prevention, intervention, and care: 2024 report of the Lancet Standing Commission. The Lancet, 404(10452), 572–628.
Muliatie, Y. E., Jannah, N., & Suprapti, S. (2021). Pencegahan demensia/Alzheimer di Desa Prigen, Kecamatan Prigen, Kabupaten Pasuruan. Prosiding PKM-CSR, 4. https://doi.org/10.37695/pkmcsr.v4i0.1308
National Institute on Aging. (2026). VCID: Conduct clinical research informed by basic research findings. U.S. Department of Health and Human Services. https://www.nia.nih.gov/research/milestones/research-resources/vcid-conduct-clinical-research-informed-basic-research
Nopia, N., & Huzaifah, S. (2020). Analisis faktor gangguan fungsi kognitif pasien stroke. Repository Universitas NHM. http://repository.universitasnhm.ac.id/1562/1/20142010044-2024-MANUSKRIP.pdf
Nurleny, N., Hasni, H., Yazia, V., Kontesa, M., & Suryani, U. (2021). Melatih kognitif melalui terapi puzzle terhadap tingkat demensia lansia di Panti Sosial Tresna Werdha Sabai Nan Aluih Sicincin Padang Pariaman Tahun 2021. Jurnal Abdimas Saintika, 3(2), 109–118. https://doi.org/10.30633/jas.v3i2.1239
O'Brien, J. T., & Thomas, A. (2015). Vascular dementia. The Lancet, 386(10004), 1698–1706. https://doi.org/10.1016/S0140-6736(15)00463-8
Perhimpunan Dokter Spesialis Saraf Indonesia. (2023). Pedoman praktik klinis neurologi 2023. PERDOSSI.
Pinto, T. C. C., Machado, L., Bulgacov, T. M., Rodrigues-Júnior, A. L., Costa, M. L. G., Ximenes, R. C. C., & Sougey, E. B. (2019). Is the Montreal Cognitive Assessment (MoCA) screening superior to the Mini-Mental State Examination (MMSE) in the detection of mild cognitive impairment (MCI) and Alzheimer's disease (AD) in the elderly? International Psychogeriatrics, 31(4), 491–504. https://doi.org/10.1017/S1041610218001370
Sachdev, P. S., Bentvelzen, A. C., Gustafson, D., Hansra, G. K., Hosoki, S., Jiang, J., et al. (2026). VCID: Clinical features, neuropathology, and biomarkers. Journal of the American College of Cardiology, 87(1), 52–76. https://doi.org/10.1016/j.jacc.2025.11.008
Silva, N. C. B. S., Bracko, O., Nelson, A. R., Oliveira, F. F., Robison, L. S., Shaaban, E. C., Hainsworth, A. H., & Price, B. R. (2022). VCID: Perspectives from early career researchers. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, 14(1), e12310. https://doi.org/10.1002/dad2.12310
Siregar, I. K. (2023). Gangguan kognitif pasca-stroke: Tinjauan sistematik. CDK Journal.
Skrobot, O. A., Black, S. E., Chen, C., DeCarli, C., Erkinjuntti, T., Ford, G. A., ... & O'Brien, J. T. (2018). Progress toward standardized diagnosis of vascular cognitive impairment: Guidelines from the Vascular Impairment of Cognition Classification Consensus Study. Alzheimer's & Dementia, 14(3), 280–292. https://doi.org/10.1016/j.jalz.2017.09.007
Teunissen, C. E., Verberk, I. M. W., Thijssen, E. H., Vermunt, L., Hansson, O., Zetterberg, H., van der Flier, W. M., Mielke, M. M., & del Campo, M. (2022). Blood-based biomarkers for Alzheimer's disease: Towards clinical implementation. The Lancet Neurology, 21(1), 66–77. https://doi.org/10.1016/S1474-4422(21)00361-6
Van der Flier, W. M., Skoog, I., Schneider, J. A., Pantoni, L., Mok, V., Chen, C. L. H., & Scheltens, P. (2018). Vascular cognitive impairment. Nature Reviews Disease Primers, 4, 18003. https://doi.org/10.1038/nrdp.2018.3
Wardlaw, J. M., Smith, C., & Dichgans, M. (2019). Small vessel disease: Mechanisms and clinical implications. The Lancet Neurology, 18(7), 684–696. https://doi.org/10.1016/S1474-4422(19)30079-1
World Health Organization. (2023). Dementia. https://www.who.int/news-room/fact-sheets/detail/dementia
World Stroke Organization. (2022). World Stroke Organization global stroke fact sheet 2022. International Journal of Stroke, 17(1), 18–29.
Wulandari, A. L., Pangastuti, H. S., & Effendy, C. (2020). Self-efficacy family caregiver dalam merawat pasien demensia: Studi deskriptif di RSUP Dr. Sardjito, Indonesia. Jurnal Keperawatan Klinis dan Komunitas, 4(2), 52–61. https://doi.org/10.22146/jkkk.89029
License
Copyright (c) 2026 Azka Fadila Latifa, Annisa Fitria Zahra AS, Muhammad Fatih Ma'ruf, Novad Sawelly, Dini Suryani
This work is licensed under a Creative Commons Attribution 4.0 International License.
Jurnal Biologi Tropis is licensed under a Creative Commons Attribution 4.0 International License.
The copyright of the received article shall be assigned to the author as the owner of the paper. The intended copyright includes the right to publish the article in various forms (including reprints). The journal maintains the publishing rights to the published articles.
Authors are permitted to disseminate published articles by sharing the link/DOI of the article at the journal. Authors are allowed to use their articles for any legal purposes deemed necessary without written permission from the journal with an acknowledgment of initial publication to this journal.
