TY - CHAP M1 - Book, Section TI - Vascular Dementia A1 - Kramer, Joel A1 - Seeley, William W. A1 - Miller, Bruce L. A2 - Jameson, J. Larry A2 - Fauci, Anthony S. A2 - Kasper, Dennis L. A2 - Hauser, Stephen L. A2 - Longo, Dan L. A2 - Loscalzo, Joseph PY - 2018 T2 - Harrison's Principles of Internal Medicine, 20e AB - Vascular cognitive impairment and vascular dementia (VCI-VaD) denote deficits in cognition and behavior, along a spectrum of severity, that are associated with cerebrovascular disease (CVD). A dementia syndrome results when CVD is severe enough to cause significant deficits in occupational, social, or functional abilities. VaD is among the most common causes of dementia in the elderly, although its prevalence is disputed. Vascular disease can disrupt structural cognitive networks with lesions such as microinfarcts, microbleeds, macroinfarcts, large hemorrhages, and chronic progressive white matter degeneration, as well as altered cerebral hemodynamics, such as hypoperfusion, disrupted cerebrovascular autoregulation (Chap. 301) neurovascular decoupling (loss of normal hemodynamic responses to neural activity), and blood brain barrier dysfunction. The pathophysiological underpinnings of VCI-VaD remain an active area of research. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/19 UR - accessmedicine.mhmedical.com/content.aspx?aid=1155958600 ER -