Box 3.

Vascular cognitive impairment – present and past.^3,9,15,16,19

The term “Vascular cognitive impairment” refers to the cognitive impairment due to cerebrovascular disease, encompassing all levels of cognitive decline, from the brain-at risk stage, passing across an intermediate not-dementia phase, and finally ending in the plainly expressed “Vascular dementia”.15,16

Among the several types of vascular lesion that may be found, one of the most frequent is subcortical white matter affection (white matter atrophy), due to chronic cerebral ischemia, described by Binswanger, and acknowledged by Alzheimer, as a “subform of arteriosclerotic brain atrophy”. Alzheimer provided a separate description of this subform, resulting from his own observations, and where the autopsy showed a “severe arteriosclerotic disease of the long vessels of the deep white matter” with highly atrophic hemispheric white matter.3,9,19