Cognitive impairment in sporadic cerebral small vessel disease: A systematic review and meta-analysis

Alzheimers Dement. 2021 Apr;17(4):665-685. doi: 10.1002/alz.12221. Epub 2020 Nov 13.


This paper is a proposal for an update on the characterization of cognitive impairments associated with sporadic cerebral small vessel disease (SVD). We pose a series of questions about the nature of SVD-related cognitive impairments and provide answers based on a comprehensive review and meta-analysis of published data from 69 studies. Although SVD is thought primarily to affect executive function and processing speed, we hypothesize that SVD affects all major domains of cognitive ability. We also identify low levels of education as a potentially modifiable risk factor for SVD-related cognitive impairment. Therefore, we propose the use of comprehensive cognitive assessments and the measurement of educational level both in clinics and research settings, and suggest several recommendations for future research.

Keywords: cerebral small vessel disease; cognitive ability; lacunar stroke; meta-analysis; systematic review; vascular cognitive impairment; vascular dementia.

Publication types

  • Meta-Analysis
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Aging / physiology
  • Cerebral Small Vessel Diseases / complications*
  • Cognition*
  • Cognitive Dysfunction / etiology*
  • Educational Status*
  • Executive Function
  • Humans
  • Magnetic Resonance Imaging
  • Neuropsychological Tests*
  • Stroke / complications