Hand pointing to White Matter Hyperintensitities on an MRI
Diverse VCID

Consequences of Brain White Matter Lesions for Dementia Risk in Diverse Individuals Across the U.S.

Young African-American doctor reviewing a tablet with an older African-American patient


As awareness of dementia increases, it is common for individuals to seek clinical evaluation for cognitive complaints.

Black American and Hispanic/Latinx Americans are at greater risk than White Americans for developing dementia, likely reflecting historical and present-day systemic racism and social inequities that affect brain health.  In fact, social determinants of health strongly contribute to the increased prevalence of vascular brain disease in older adult populations from diverse backgrounds. Neuroimaging studies performed as part of cognitive assessment frequently identify incidental White Matter Hyperintensitites (WMH), usually ascribed to microvascular disease by radiologists, raising patient concerns about their brain health and future risk for dementia.

To date, however, we are not aware of any studies that have comprehensively examined the impact of individual and combined MRI measures of white matter injury on cognitive performance among a diverse, non-demented, stroke free population with cognitive complaints over an extended period of observation. To study this problem directly, the US National Institute of Neurological Disorders and Stroke (NINDS) has commissioned Dr. DeCarli and Dr. Fornage to design and implement Diverse VCID, a 6-year study of 2,250 Americans from diverse backgrounds to understand the role that WMH play in developing Alzheimer's disease and other dementias.

The results of this study will be used to develop and validate a predictive risk model to inform future care.

What is Diverse Vascular Contributions to Cognitive Impairment and Dementia (VCID)?

Hispanic Man Drinking Coffee Looking Out a Window



illustration of white matter hyperintensitites seen on a brain scan


Vascular Contributions to Cognitive Impairment and Dementia (VCID) is defined as memory or thinking problems due to vascular disease.  Our blood circulatory systems affect our brain health. Cerebrovascular disease (vascular disease affecting the brain) reduces blood flow, causes abnormal signals in the white matter of the brain called white matter hyperintensities, and small holes in the brain called infarcts.  MRI can detect these changes.

These changes can affect memory and thinking skills, and when severe, can lead to higher risk of developing dementia, including Alzheimer's. 

We use vascular contributions to cognitive impairment or dementia (VCID) as a term to indicate problems with memory and thinking that result from vascular brain injury.