{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T21:41:24Z","timestamp":1789594884699,"version":"build-2803163510"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Vascular cognitive impairment and dementia (VCID) is common in the ageing population. VCID is often the cause of alterations in vascular perfusion or function, reflected for example in strokes, haemorrhages, and small vessel disease. The risk of developing VCID is accelerated by the presence of cardiovascular risk factors like hypertension, hyperlipidemia, diabetes mellitus, smoking, and atrial fibrillation. Symptoms of VCID vary depending on the brain regions affected and the extent of blood flow disruption. Common early signs include slowed thinking, difficulty planning or organizing, trouble concentrating, confusion, and changes in mood or behaviour. Motor function disturbances in gait and balance are increasingly recognized as early features, and functional consequences may well be aggravated in the presence of multi-domain impairment in motor function as well as cognition. While some patients experience sudden onset of these symptoms following a cerebrovascular event, many experience a gradual progression of symptoms due to cerebral small vessel damage. In the absence of a cure for VCID, emphasis on clinical treatment is on timely preventive interventions as well as supportive care and management. The collection of selected studies on VCID published in Age and Ageing provides an overview of the impact of modifiable risk factors on motor function impairment as well as cognitive symptoms, and points towards developments in preventative risk factor management and recent combined cognitive-motor interventions aimed at maintaining cognitive and functional ability.<\/jats:p>","DOI":"10.1093\/ageing\/afaf298","type":"journal-article","created":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T11:59:32Z","timestamp":1759406372000},"source":"Crossref","is-referenced-by-count":4,"title":["Vascular cognitive impairment and dementia in old age: cognition and beyond"],"prefix":"10.1093","volume":"54","author":[{"given":"Ana Charlotte","family":"Menart","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Erasmus MC University Medical Center , Rotterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2989-4063","authenticated-orcid":false,"given":"Lisanne","family":"Tap","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine, Department of Internal Medicine and Alzheimer Center, Erasmus MC University Medical Center , Rotterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank J","family":"Wolters","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Erasmus MC University Medical Center , Rotterdam ,","place":["The Netherlands"]},{"name":"Department of Radiology & Nuclear Medicine and Alzheimer Center, Erasmus MC University Medical Center , Rotterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1688-6497","authenticated-orcid":false,"given":"Francesco","family":"Mattace-Raso","sequence":"additional","affiliation":[{"name":"Division of Geriatric Medicine, Department of Internal Medicine and Alzheimer Center, Erasmus MC University Medical Center , Rotterdam ,","place":["The Netherlands"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,11,3]]},"reference":[{"key":"2025110220255198800_ref1","doi-asserted-by":"crossref","first-page":"908915","DOI":"10.1155\/2014\/908915","article-title":"Global epidemiology of dementia: Alzheimer's and vascular types","volume":"2014","author":"Rizzi","year":"2014","journal-title":"Biomed Res Int"},{"key":"2025110220255198800_ref2","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1002\/ana.25380","article-title":"Attributable risk of Alzheimer's dementia attributed to age-related neuropathologies","volume":"85","author":"Boyle","year":"2019","journal-title":"Ann Neurol"},{"key":"2025110220255198800_ref3","first-page":"804","article-title":"Varied effects of age-related neuropathologies on the trajectory of late life cognitive decline","volume":"140","author":"Boyle","year":"2017","journal-title":"Brain."},{"key":"2025110220255198800_ref4","doi-asserted-by":"publisher","first-page":"1288","DOI":"10.1001\/jamaneurol.2015.2161","article-title":"Association between atrial fibrillation and dementia in the general population","volume":"72","author":"Bruijn","year":"2015","journal-title":"JAMA Neurol"},{"key":"2025110220255198800_ref5","doi-asserted-by":"publisher","first-page":"1229","DOI":"10.1093\/europace\/euac003","article-title":"Predictive role of atrial fibrillation in cognitive decline: a systematic review and meta-analysis of 2.8 million individuals","volume":"24","author":"Koh","year":"2022","journal-title":"Europace."},{"key":"2025110220255198800_ref6","doi-asserted-by":"publisher","first-page":"2313","DOI":"10.1093\/eurheartj\/ehz386","article-title":"Risk of dementia in stroke-free patients diagnosed with atrial fibrillation: data from a population-based cohort","volume":"40","author":"Kim","year":"2019","journal-title":"Eur Heart J"},{"key":"2025110220255198800_ref7","doi-asserted-by":"publisher","first-page":"995","DOI":"10.1093\/ageing\/afaa106","article-title":"Dual decline in gait speed and cognition is associated with future dementia: evidence for a phenotype","volume":"49","author":"Montero-Odasso","year":"2020","journal-title":"Age Ageing"},{"key":"2025110220255198800_ref8","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1093\/ageing\/afaa126","article-title":"Walking in humans: how much brain function is needed?","volume":"49","author":"Kressig","year":"2020","journal-title":"Age Ageing"},{"key":"2025110220255198800_ref9","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afae161","article-title":"Associations of 10-year atherosclerotic cardiovascular disease risk scores with cerebral small vessel disease: the PolyvasculaR evaluation for cognitive impairment and vaScular events (PRECISE) study","volume":"53","author":"Liu","year":"2024","journal-title":"Age Ageing"},{"key":"2025110220255198800_ref10","doi-asserted-by":"publisher","first-page":"452","DOI":"10.1038\/s41581-020-0266-9","article-title":"Mechanisms of cognitive dysfunction in CKD","volume":"16","author":"Viggiano","year":"2020","journal-title":"Nat Rev Nephrol"},{"key":"2025110220255198800_ref11","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afab259","article-title":"Association between kidney function and incidence of dementia: 10-year follow-up of the Whitehall II cohort study","volume":"51","author":"Singh-Manoux","year":"2022","journal-title":"Age Ageing"},{"key":"2025110220255198800_ref12","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afae240","article-title":"Associations between amyloid-beta load and cognition in cerebrovascular disease beyond cerebral amyloid angiopathy: a systematic review and meta-analysis of positron emission tomography studies","volume":"53","author":"Zhang","year":"2024","journal-title":"Age Ageing"},{"key":"2025110220255198800_ref13","doi-asserted-by":"publisher","first-page":"729","DOI":"10.1093\/ageing\/afx084","article-title":"Motor function and incident dementia: a systematic review and meta-analysis","volume":"46","author":"Kueper","year":"2017","journal-title":"Age Ageing"},{"key":"2025110220255198800_ref14","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afad148","article-title":"New horizons in cognitive and functional impairment as a consequence of cerebral small vessel disease","volume":"52","author":"Tap","year":"2023","journal-title":"Age Ageing"},{"key":"2025110220255198800_ref15","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afaf013","article-title":"Behavioural and psychological symptoms of people with dementia in acute hospital settings: a systematic review and meta-analysis","volume":"54","author":"Anantapong","year":"2025","journal-title":"Age Ageing"},{"key":"2025110220255198800_ref16","doi-asserted-by":"publisher","DOI":"10.14336\/AD.2024.1073","article-title":"Chronic cerebral deterioration - a comprehensive view of old-age cerebral deterioration","author":"Dalen","year":"2025","journal-title":"Aging Dis"},{"key":"2025110220255198800_ref17","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1093\/ageing\/afw185","article-title":"The relative temporal sequence of decline in mobility and cognition among initially unimpaired older adults: results from the Baltimore longitudinal study of aging","volume":"46","author":"Tian","year":"2017","journal-title":"Age Ageing"},{"key":"2025110220255198800_ref18","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.1007\/s10654-024-01160-2","article-title":"Family history of dementia and brain health in childhood and middle age: a prospective community-based study","volume":"39","author":"Hussainali","year":"2024","journal-title":"Eur J Epidemiol"},{"key":"2025110220255198800_ref19","doi-asserted-by":"publisher","first-page":"75","DOI":"10.1093\/gerona\/glw122","article-title":"Simple test of manual dexterity can help to identify persons at high risk for neurodegenerative diseases in the community","volume":"72","author":"Darweesh","year":"2017","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"2025110220255198800_ref20","doi-asserted-by":"publisher","first-page":"e209699","DOI":"10.1212\/WNL.0000000000209699","article-title":"Long-term dementia risk in Parkinson disease","volume":"103","author":"Gallagher","year":"2024","journal-title":"Neurology."},{"key":"2025110220255198800_ref21","doi-asserted-by":"publisher","first-page":"1342","DOI":"10.1093\/ageing\/afab038","article-title":"Balance and cognitive decline in older adults in the cardiovascular health study","volume":"50","author":"Meunier","year":"2021","journal-title":"Age Ageing"},{"key":"2025110220255198800_ref22","doi-asserted-by":"publisher","first-page":"619","DOI":"10.1093\/ageing\/afl107","article-title":"Association of executive function and performance of dual-task physical tests among older adults: analyses from the InChianti study","volume":"35","author":"Coppin","year":"2006","journal-title":"Age Ageing"},{"key":"2025110220255198800_ref23","doi-asserted-by":"publisher","first-page":"2127","DOI":"10.1111\/j.1532-5415.2012.04209.x","article-title":"Gait and cognition: a complementary approach to understanding brain function and the risk of falling","volume":"60","author":"Montero-Odasso","year":"2012","journal-title":"J Am Geriatr Soc"},{"key":"2025110220255198800_ref24","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1016\/j.arr.2014.06.001","article-title":"Single and dual task tests of gait speed are equivalent in the prediction of falls in older people: a systematic review and meta-analysis","volume":"16","author":"Menant","year":"2014","journal-title":"Ageing Res Rev"},{"key":"2025110220255198800_ref25","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1093\/ageing\/afy059","article-title":"New horizons in falls prevention","volume":"47","author":"Lord","year":"2018","journal-title":"Age Ageing"},{"key":"2025110220255198800_ref26","doi-asserted-by":"publisher","first-page":"4980","DOI":"10.1093\/eurheartj\/ehac584","article-title":"Blood pressure lowering and prevention of dementia: an individual patient data meta-analysis","volume":"43","author":"Peters","year":"2022","journal-title":"Eur Heart J"},{"key":"2025110220255198800_ref27","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1001\/jama.2018.21442","article-title":"Effect of intensive vs standard blood pressure control on probable dementia: a randomized clinical trial","volume":"321","author":"Group SMIftSR","year":"2019","journal-title":"JAMA."},{"key":"2025110220255198800_ref28","doi-asserted-by":"publisher","first-page":"2054","DOI":"10.1038\/s41591-025-03616-8","article-title":"Blood pressure reduction and all-cause dementia in people with uncontrolled hypertension: an open-label, blinded-endpoint, cluster-randomized trial","volume":"31","author":"He","year":"2025","journal-title":"Nat Med"},{"key":"2025110220255198800_ref29","doi-asserted-by":"publisher","first-page":"720","DOI":"10.1001\/jamaneurol.2017.5153","article-title":"Effect of standard vs intensive blood pressure control on cerebral blood flow in small vessel disease: the PRESERVE randomized clinical trial","volume":"75","author":"Croall","year":"2018","journal-title":"JAMA Neurol"},{"key":"2025110220255198800_ref30","doi-asserted-by":"publisher","first-page":"578","DOI":"10.1001\/jamainternmed.2014.8164","article-title":"Effects of low blood pressure in cognitively impaired elderly patients treated with antihypertensive drugs","volume":"175","author":"Mossello","year":"2015","journal-title":"JAMA Intern Med"},{"key":"2025110220255198800_ref31","doi-asserted-by":"publisher","first-page":"545","DOI":"10.1093\/ageing\/afy072","article-title":"Lower blood pressure during antihypertensive treatment is associated with higher all-cause mortality and accelerated cognitive decline in the oldest-old. Data from the Leiden 85-plus study","volume":"47","author":"Streit","year":"2018","journal-title":"Age Ageing"},{"key":"2025110220255198800_ref32","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afae133","article-title":"Effects of the discontinuation of antihypertensive treatment on neuropsychiatric symptoms and quality of life in nursing home residents with dementia (DANTON): a multicentre, open-label, blinded-outcome, randomised controlled trial","volume":"53","author":"Bogaerts","year":"2024","journal-title":"Age Ageing"},{"key":"2025110220255198800_ref33","doi-asserted-by":"publisher","first-page":"1622","DOI":"10.1001\/jamainternmed.2015.4103","article-title":"Effect of discontinuation of antihypertensive treatment in elderly people on cognitive functioning--the DANTE study Leiden: a randomized clinical trial","volume":"175","author":"Moonen","year":"2015","journal-title":"JAMA Intern Med"},{"key":"2025110220255198800_ref34","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.neubiorev.2018.10.025","article-title":"Oral anticoagulants and risk of dementia: a systematic review and meta-analysis of observational studies and randomized controlled trials","volume":"96","author":"Mongkhon","year":"2019","journal-title":"Neurosci Biobehav Rev"},{"key":"2025110220255198800_ref35","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afae021","article-title":"Adherence to the atrial fibrillation better care pathway and the risk of adverse health outcomes in older care home residents with atrial fibrillation: a retrospective data linkage study 2003-18","volume":"53","author":"Ritchie","year":"2024","journal-title":"Age Ageing"},{"key":"2025110220255198800_ref36","doi-asserted-by":"publisher","first-page":"994085","DOI":"10.3389\/fcvm.2022.994085","article-title":"Adherence and persistence to oral anticoagulants in patients with atrial fibrillation: a Belgian nationwide cohort study","volume":"9","author":"Grymonprez","year":"2022","journal-title":"Front Cardiovasc Med"},{"key":"2025110220255198800_ref37","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afad038","article-title":"Comparing the risk of dementia in subjects with atrial fibrillation using non-vitamin K antagonist oral anticoagulants versus vitamin K antagonists: a Belgian nationwide cohort study","volume":"52","author":"Grymonprez","year":"2023","journal-title":"Age Ageing"},{"key":"2025110220255198800_ref38","article-title":"Antiplatelet therapy and incident cognitive impairment or dementia-a systematic review and meta-analysis of randomised clinical trials","volume":"52","author":"Kitt","year":"2023","journal-title":"Age Ageing"},{"key":"2025110220255198800_ref39","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afae009","article-title":"Effects of rhythm-control and rate-control strategies on cognitive function and dementia in atrial fibrillation: a systematic review and meta-analysis","volume":"53","author":"Guo","year":"2024","journal-title":"Age Ageing"},{"key":"2025110220255198800_ref40","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1186\/s12872-025-04867-6","article-title":"Efficacy and safety of anticoagulants in elderly atrial fibrillation patients: a systematic review and network meta-analysis","volume":"25","author":"Zhao","year":"2025","journal-title":"BMC Cardiovasc Disord"},{"key":"2025110220255198800_ref41","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afad067","article-title":"Long-term beneficial impact of the randomised trial 'train the brain', a motor\/cognitive intervention in mild cognitive impairment people: effects at the 14-month follow-up","volume":"52","author":"Sale","year":"2023","journal-title":"Age Ageing"},{"key":"2025110220255198800_ref42","doi-asserted-by":"publisher","first-page":"1084","DOI":"10.1093\/ageing\/afaa270","article-title":"Effects of dance on cognitive function in older adults: a systematic review and meta-analysis","volume":"50","author":"Hewston","year":"2021","journal-title":"Age Ageing"},{"key":"2025110220255198800_ref43","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1093\/ageing\/afu175","article-title":"Cognitive motor interference for preventing falls in older adults: a systematic review and meta-analysis of randomised controlled trials","volume":"44","author":"Wang","year":"2015","journal-title":"Age Ageing"}],"container-title":["Age and Ageing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ageing\/article-pdf\/54\/11\/afaf298\/65038331\/afaf298.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ageing\/article-pdf\/54\/11\/afaf298\/65038331\/afaf298.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T01:25:57Z","timestamp":1762133157000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ageing\/article\/doi\/10.1093\/ageing\/afaf298\/8306456"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,30]]},"references-count":43,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,10,30]]}},"URL":"https:\/\/doi.org\/10.1093\/ageing\/afaf298","relation":{},"ISSN":["0002-0729","1468-2834"],"issn-type":[{"value":"0002-0729","type":"print"},{"value":"1468-2834","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,11]]},"published":{"date-parts":[[2025,10,30]]},"article-number":"afaf298"}}