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Vascular cognitive impairment (VCI) is probably the most common form of acquired cognitive impairment. It needs to be better identified as it is a potentially treatable condition. Mild VCI appears in patients with various vascular diseases, for example congestive heart failure. When the cognitive impairment is pronounced the term dementia is used. Vascular dementia comprises various sub- or supertypes, such as subcortical vascular dementia, stroke-related dementia and mixed type dementia (Alzheimer's disease plus cerebrovascular disease). The clinical diagnoses are based on symptom assessment, with executive dysfunction being a characteristic finding, structural brain imaging, and cerebrospinal fluid determinations. There is not yet any approved pharmacological treatment of VCI and evidence for life style intervention as an efficient method is still lacking. Nevertheless, there is promising unapplied knowledge. If what is known about symptom presentation and subtypes of VCI is applied in the design of forthcoming trials, the probabilities of finding significant effects will increase.

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