Fig. 1

Stepwise progression to VaD. The road from risk factors to disease manifestation in VCI is a complicated one, as the multiple demographics, lifestyle and comorbid disease risk and mitigating factors interact through the progression from asymptomatic vascular lesions, cognitive impairment, and finally to VaD. Furthermore, these complex interactions give rise to several distinct cerebrovascular diseases underlying different forms of vascular brain injuries, leading to the clinical heterogeneity of VaD. However, regardless of the specific nature of vascular injury (occlusive, thrombotic, etc.), a state of chronic cerebral hypoperfusion can be considered to be the common etiological link. *See Table 1 for details and summary of supporting research