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(Stroke. 2009;40:S40.)
© 2009 American Heart Association, Inc.

Vascular Cognitive Impairment

Threats to the Mind

Aging, Amyloid, and Hypertension

Costantino Iadecola, MD; Laibaik Park, PhD Carmen Capone, PhD

From the Division of Neurobiology, Department of Neurology and Neuroscience, Weill Medical College of Cornell University, New York.

Correspondence to C. Iadecola, MD, Division of Neurobiology, Weill Medical College of Cornell University, 411 East 69th Street; KB410, New York, NY 10021. E-mail coi2001{at}med.cornell.edu

Aging, Alzheimer disease, and hypertension, major determinants of cognitive dysfunction, are associated with profound alterations in the structure and function of cerebral blood vessels. These vascular alterations may impair the delivery of energy substrates and nutrients to the active brain, and impede the clearance of potentially toxic metabolic byproducts. Reactive oxygen species derived form the enzyme NADPH oxidase are key pathogenic effectors of the cerebrovascular dysregulation. The resulting alterations in the homeostasis of the cerebral microenvironment may lead to cellular dysfunction and death and to cognitive impairment. The prominent role that cerebrovascular oxidative stress plays in conditions associated with cognitive impairment suggests new therapeutic opportunities to counteract and, possibly, reverse the devastating effects of cerebrovascular dysfunction on the brain.

Key Words: dementia • VCI

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