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. In addition, CVD frequently contributes to cognitive loss in patients with Alzheimer's disease (AD). Progress in understanding the pathogenetic mechanism involved in vascular cognitive impairment (VCI) 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 inhibitor agents used in AD. Controlled clinical trials with donepezil, galantamine and rivastigmine in VaD, as well as in patients with AD plus CVD, have demonstrated improvements in cognition, behavior and activities of daily living.
Erkinjuntti
Timo
T
Helsinki University Central Hospital, Helsinki, Finland. Timo.Erkinjuntti@HUS.fi
Román
Gustavo
G
Gauthier
Serge
S
D000368:Aged; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D015140:Dementia, Vascular / Q000188:drug therapy* / Q000503:physiopathology; D000077265:Donepezil; D005702:Galantamine / Q000627:therapeutic use; D006801:Humans; D007189:Indans / Q000627:therapeutic use; D018697:Nootropic Agents / Q000627:therapeutic use; D010275:Parasympathetic Nervous System / Q000503:physiopathology; D048448:Phenylcarbamates / Q000627:therapeutic use; D010880:Piperidines / Q000627:therapeutic use; D000068836:Rivastigmine
D002800:Cholinesterase Inhibitors; D007189:Indans; D018697:Nootropic Agents; D048448:Phenylcarbamates; D010880:Piperidines; D005702:Galantamine; D000077265:Donepezil; D000068836:Rivastigmine