The Effects of Diabetes on the Neurovascular Unit in Vascular Cognitive Impairment and Dementia

Abstract

Vascular cognitive impairment and dementia (VCID) is the second most prevalent form of dementia accounting for ~20% of all dementia diagnoses. Dementia is an umbrella term that initiates mild to severe cognitive impairment in the form of memory loss, confusion, and impaired judgment. With vascular and brain health directly related, the term VCID has been coined to describe effects of vascular dysfunction and vascular disease on brain health and neurodegeneration. The neurovascular unit (NVU) describes the relationship between brain cells and the surrounding cerebral vascular cells. Recent reports Although mechanisms that occur within the NVU are not well understood, they could potentially provide key insight into understanding VCID development and progression. Diabetes is a known vascular risk factor for NVU dysfunction and ischemic stroke. It has been identified that comorbid conditions such as diabetes increase the risks of post-stroke cognitive impairment (PSCI) and worsened outcomes such as VCID. This review article will describe the impact of diabetic induced ischemic injury on brain microvasculature. Recent research has incorporated preclinical VCID models to investigate the connection between diabetes, NVU dysfunction, and cognitive impairment. Specifically, this article will bring much attention to current findings in VCID research in relation to diabetic complications such as impaired cerebral blood flow (CBF), vascular restructuring, and compromised NVU function.