VCAM-1 in Cognitive Impairment: Mechanisms, Biomarker Potential, and Therapeutic Targeting.

Cognitive impairment (CI), a progressive decline in memory, reasoning, and executive functions, arises from neurodegenerative and cerebrovascular pathologies. Globally, 10% of adults aged ≥65 exhibit mild CI (MCI), with 15% progressing annually to dementia. Alzheimer's disease (AD) constitutes 60-70% of dementia cases, showing a higher incidence in women, while vascular dementia (VaD) accounts for 20%. By 2050, dementia cases may reach 152 million, straining healthcare systems. Vascular cell adhesion molecule 1 (VCAM-1), a key immune-inflammatory mediator, is implicated in CI pathogenesis. Expressed abundantly on endothelial cells, VCAM-1 disrupts blood-brain barrier (BBB) integrity and exacerbates neuroinflammation. This review delineates VCAM-1's role in BBB dysregulation, neuroinflammatory interactions, and its potential as a biomarker/therapeutic target. Future research should clarify VCAM-1 signaling mechanisms and develop targeted interventions for early CI management.