Dementia is a global problem and major target for
health care providers. Although up to 45% of cases are primarily or partly due
to cerebrovascular disease, little is known of these mechanisms or treatments
because most dementia research still focuses on pure Alzheimer's disease. An
improved understanding of the vascular contributions to neurodegeneration and
dementia, particularly by small vessel disease, is hampered by imprecise data,
including the incidence and prevalence of symptomatic and clinically “silent”
cerebrovascular disease, long-term outcomes (cognitive, stroke, or functional),
and risk factors. New large collaborative studies with long follow-up are
expensive and time consuming, yet substantial data to advance the field are
available. In an initiative funded by the Joint Programme for Neurodegenerative
Disease Research, 55 international experts surveyed and assessed available data,
starting with European cohorts, to promote data sharing to advance understanding
of how vascular disease affects brain structure and function, optimize methods
for cerebrovascular disease in neurodegeneration research, and focus future
research on gaps in knowledge. Here, we summarize the results and
recommendations from this initiative. We identified data from over 90 studies,
including over 660,000 participants, many being additional to neurodegeneration
data initiatives. The enthusiastic response means that cohorts from North
America, Australasia, and the Asia Pacific Region are included, creating a truly
global, collaborative, data sharing platform, linked to major national dementia
initiatives. Furthermore, the revised World Health Organization International
Classification of Diseases version 11 should facilitate recognition of
vascular-related brain damage by creating one category for all cerebrovascular
disease presentations and thus accelerate identification of targets for dementia
prevention.
