Emerging Therapies for Vascular Dementia and Vascular Cognitive Impairment

Timo Erkinjuntti, Gustavo Román, Serge Gauthier, Howard Feldman, Kenneth Rockwood

Research output: Contribution to journalArticle

170 Scopus citations

Abstract

Background-Cerebrovascular disease (CVD) and ischemic brain injury secondary to cardiovascular disease are common causes of dementia and cognitive decline in the elderly. CVD also contributes to cognitive loss in Alzheimer disease (AD). Summary-Progress in understanding vascular cognitive impairment (VCI) and vascular dementia (VaD) has resulted in promising symptomatic and preventive treatments. Cholinergic deficits in VaD due to ischemia of basal forebrain nuclei and cholinergic pathways can be treated with cholinesterase inhibitors used in AD. Controlled clinical trials with donepezil and galantamine in patients with VaD, as well as in patients with AD plus CVD, have demonstrated improvement in cognition, behavior, and activities of daily living. The N-methyl-D-aspartate receptor antagonist memantine stabilized progression of VaD compared with placebo. Primary and secondary stroke prevention, in particular with control of hypertension and hyperlipidemia, can decrease VaD incidence. Conclusions-From a public health viewpoint, recognition of VCI before the development of dementia and correction of vascular burden on the brain may lead to a global decrease of incident dementia.

Original languageEnglish (US)
Pages (from-to)1010-1017
Number of pages8
JournalStroke
Volume35
Issue number4
DOIs
StatePublished - Apr 2004

Keywords

  • Carbamates
  • Cognitive disorders
  • Dementia
  • Donepezil
  • Galantamine
  • Memantine
  • Nimodipine
  • Piperidines
  • Rivastigmine
  • Vascular diseases

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Neuroscience(all)

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