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Vascular cognitive impairment and dementia: Prevention, treatments, mechanisms and management options for the future
Matthew J. Lennon, Perminder Singh Sachdev. Neuropsychopharmacology, 2026-01-19
Topic: Risk, prevention and care in population studies
Vascular Cognitive Impairment and Dementia (VCID), the second most common form of dementia, is becoming increasingly prevalent worldwide. However, currently there are no FDA-approved therapies for VCID. In this review, we explore treatments with extant supporting evidence as well as treatments in development and outline the path forward for future research. Donepezil, rivastigmine, and memantine all have some evidence as cognitive enhancers in patients with Vascular Dementia (VaD) and are approved in several non-US jurisdictions. Nutraceuticals, such as Ginkgo biloba and butylphthalide, have some supportive data and may be similarly helpful. Prevention of VCID is an important objective, and there is support for the intensive control of hypertension and treatment of hyperglycemia to prevent cognitive decline. Asymptomatic cerebral small vessel disease is commonly detected in neuropsychiatric cohorts and healthy individuals, and protocols and trials are being developed to help guide management to minimize the risk of cognitive impairment. A range of novel treatment strategies, including noninvasive neurostimulation, stimulant treatment, and neurotrophic factors, are being explored. Future research into VCID treatment needs to incorporate a range of novel technologies, including blood-based biomarkers, automation of brain image segmentation and quantification using artificial intelligence, automated remotely administered neuropsychological testing, and rational drug discovery.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Lennon, M. J., & Sachdev, P. S. (2026). Vascular cognitive impairment and dementia: Prevention, treatments, mechanisms and management options for the future. Neuropsychopharmacology. https://doi.org/10.1038/s41386-026-02331-3
Vancouver
Lennon MJ, Sachdev PS. Vascular cognitive impairment and dementia: Prevention, treatments, mechanisms and management options for the future. Neuropsychopharmacology. 2026. doi:10.1038/s41386-026-02331-3. PMID: 41554956.
BibTeX
@article{lennon2026-41554956,
author = {Lennon, Matthew J. and Sachdev, Perminder Singh},
title = {{Vascular cognitive impairment and dementia: Prevention, treatments, mechanisms and management options for the future}},
journal = {Neuropsychopharmacology},
year = {2026},
doi = {10.1038/s41386-026-02331-3},
pmid = {41554956},
url = {https://doi.org/10.1038/s41386-026-02331-3}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- Nutraceuticals, such as Ginkgo biloba and butylphthalide, have some supportive data and may be similarly helpful.
- Prevention of VCID is an important objective, and there is support for the intensive control of hypertension and treatment of hyperglycemia to prevent cognitive decline.
- Asymptomatic cerebral small vessel disease is commonly detected in neuropsychiatric cohorts and healthy individuals, and protocols and trials are being developed to help guide management to minimize the risk of cognitive impairment.
- A range of novel treatment strategies, including noninvasive neurostimulation, stimulant treatment, and neurotrophic factors, are being explored.
- Future research into VCID treatment needs to incorporate a range of novel technologies, including blood-based biomarkers, automation of brain image segmentation and quantification using artificial intelligence, automated remotely administered neuropsychological testing, and rational drug discovery.
Why it matters
There are currently no FDA-approved therapies for vascular cognitive impairment and dementia, though donepezil, rivastigmine, and memantine have some evidence as cognitive enhancers and are approved in several non-US jurisdictions. Intensive control of hypertension and treatment of hyperglycemia may help prevent cognitive decline, and novel strategies such as noninvasive neurostimulation are still being explored.
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Study details
- Evidence strengthLow
How this study scored 48/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Neuropsychopharmacology) |
| Journal's citation record | 3 / 4 | Neuropsychopharmacology: journal h-index 306 (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 | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| 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) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 10 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 5.0 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 6 / 6 | Cited 47.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 10 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Perminder Singh Sachdev: h-index 147 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | UNSW Sydney: institution h-index 1,101 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41554956) |
| Free to read | 2 / 2 | Free to read |
| Total | 48 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1038/s41386-026-02331-3
- PubMed: 41554956
- Original source →
- Free full text: Neuropsychopharmacology →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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