Treatment of vascular dementia-evidence from clinical trials with cholinesterase inhibitors.
Cerebrovascular disease (CVD), as well as secondary ischemic brain injury from cardiovascular disease, are common causes of dementia and cognitive decline in the elderly. Also, CVD frequently contributes to cognitive loss in patients with Alzheimer's disease (AD). Progress in understanding the pathogenetic mechanism involved in vascular cognitive impairment and vascular dementia (VaD) has resulted in promising treatments of these conditions. Cholinergic deficits in VaD are due to ischemia of basal forebrain nuclei and of cholinergic pathways and can be treated with the use of the cholinesterase inhibitors used in AD. Controlled clinical trials with donepezil, galantamine, and rivastigmine in VaD, as well as in patients with AD plus CVD, have demonstrated improvement in cognition, behavior and activities of daily living.
Erkinjuntti
Timo
T
Helsinki University Central Hospital, Finland.
Román
Gustavo
G
Gauthier
Serge
S
D000110:Acetylcholinesterase / Q000187:drug effects* / Q000378:metabolism; D000544:Alzheimer Disease / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D002561:Cerebrovascular Disorders / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D002799:Cholinergic Fibers / Q000187:drug effects* / Q000201:enzymology / Q000473:pathology; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D003071:Cognition / Q000187:drug effects; D015140:Dementia, Vascular / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D018697:Nootropic Agents / Q000627:therapeutic use; D016896:Treatment Outcome
D002800:Cholinesterase Inhibitors; D018697:Nootropic Agents; D000110:Acetylcholinesterase