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Vascular cognitive impairment
O'Brien JT, Erkinjuntti T, Reisberg B, Roman G, Sawada T, Pantoni L, Bowler JV, Ballard C et al.. The Lancet. Neurology, 2003-02-01
Topic: Risk, prevention and care in population studies
Cerebrovascular disease is the second most common cause of acquired cognitive impairment and dementia and contributes to cognitive decline in the neurodegenerative dementias. The current narrow definitions of vascular dementia should be broadened to recognise the important part cerebrovascular disease plays in several cognitive disorders, including the hereditary vascular dementias, multi-infarct dementia, post-stroke dementia, subcortical ischaemic vascular disease and dementia, mild cognitive impairment, and degenerative dementias (including Alzheimer's disease, frontotemporal dementia, and dementia with Lewy bodies). Here we review the current state of scientific knowledge on the subject of vascular brain burden. Important non-cognitive features include depression, apathy, and psychosis. We propose use of the term vascular cognitive impairment, which is characterised by a specific cognitive profile involving preserved memory with impairments in attentional and executive functioning. Diagnostic criteria have been proposed for some subtypes of vascular cognitive impairment, and there is a pressing need to validate and further refine these. Clinical trials in vascular cognitive impairment are in their infancy but support the value of therapeutic interventions for symptomatic treatment.
Key findings
- Here we review the current state of scientific knowledge on the subject of vascular brain burden.
- Important non-cognitive features include depression, apathy, and psychosis.
- We propose use of the term vascular cognitive impairment, which is characterised by a specific cognitive profile involving preserved memory with impairments in attentional and executive functioning.
- Diagnostic criteria have been proposed for some subtypes of vascular cognitive impairment, and there is a pressing need to validate and further refine these.
- Clinical trials in vascular cognitive impairment are in their infancy but support the value of therapeutic interventions for symptomatic treatment.
Why it matters
This 2003 review proposes the term "vascular cognitive impairment" and argues that narrow definitions of vascular dementia should be broadened, because cerebrovascular disease also contributes to cognitive decline in other dementias, including Alzheimer's disease. It describes a typical profile of preserved memory with problems in attention and executive function, and lists depression, apathy and psychosis as important non-cognitive features. The authors say the diagnostic criteria still need validating and that treatment trials were "in their infancy"; the review reports no new data and no cure or prevention.
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Study details
- Evidence strengthLow
How this study scored 58/100
Published in a leading specialty journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (The Lancet. Neurology) |
| Journal's citation record | 3 / 4 | The Lancet Neurology: journal h-index 457 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2003 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 7 / 7 | Cited 1,139 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 45.6 citations a year over 25 year(s) since 2003 |
| Impact for its field and year | 5 / 6 | Cited 24.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 51 other studies in this library |
| Still being cited | 3 / 4 | Cited 91 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Steven T. DeKosky: h-index 132 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | New York University: institution h-index 1,612 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 16 institution(s) in 5 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 12849265) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 58 / 100 | — |
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Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
O'Brien, J. T., Erkinjuntti, T., Reisberg, B., Roman, G., Sawada, T., Pantoni, L., et al. (2003). Vascular cognitive impairment. The Lancet. Neurology. https://doi.org/10.1016/s1474-4422(03)00305-3
Vancouver
O'Brien JT, Erkinjuntti T, Reisberg B, Roman G, Sawada T, Pantoni L, et al. Vascular cognitive impairment. The Lancet. Neurology. 2003. doi:10.1016/s1474-4422(03)00305-3. PMID: 12849265.
BibTeX
@article{obrien2003-12849265,
author = {O'Brien, J. T. and Erkinjuntti, T. and Reisberg, B. and Roman, G. and Sawada, T. and Pantoni, L. and Bowler, J. V. and Ballard, C. and others},
title = {{Vascular cognitive impairment}},
journal = {The Lancet. Neurology},
year = {2003},
doi = {10.1016/s1474-4422(03)00305-3},
pmid = {12849265},
url = {https://doi.org/10.1016/s1474-4422(03)00305-3}
}
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