In 2006, the NIH convened a conference, which attempted to establish a new concept, vascular cognitive impairment (VCI). The resulting document has been published1 and now, 3 years later, several of the key participants, and others, have contributed to a new book on that topic. Edited by leading authorities and joined by several eminent experts, the book addresses clinicians dealing with demented individuals in order to distribute the concept of VCI which has not been accepted unopposed.

The term VCI is supposed to cover the whole spectrum of cognitive decline which occur as a result of vascular changes to the brain. Because these changes result from a multitude of factors (haemorrhage, ischaemia, emboli, small vessel disease, etc), VCI cannot be considered a disease, but neither is it a syndrome since there is very little in common between cognitive changes resulting from different processes (eg, leucoaraiosis and those …