Pharmacological prevention and treatment of vascular dementia: approaches and perspectives.
Vascular dementia (VaD) is a common dementing illness. There are no pharmacological agents with a regulatory approval for its treatment or prevention. Review of published clinical trial reports indicates that early treatment of hypertension, a risk factor for stroke, reduces VaD risk and slows progression. However, unlike stroke, treatment of hyperlipidemia with statin class drugs or treatment of blood clotting abnormalities with acetylsalicylic acid do not appear to have an effect on VaD incidence or progression. Pharmacological agents for treatment of Alzheimer's dementia (AD) such as memantine or acetylcholinesterase inhibitors have small positive effects on cognition in VaD, which are likely due to their action on co-existing AD-related neuropathology. Drug development efforts using novel approaches such as patient stratification by their genotype are needed in order to address the increasing need for effective VaD therapeutics.
Alzheimer's Disease Prevention and Treatment Center, Orange, California, USA. abaskys@gmail.com
Andrius
A
Baskys
Jin-xiang
JX
Cheng
D000544:Alzheimer Disease / Q000188:drug therapy; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D003071:Cognition / Q000187:drug effects; D015140:Dementia, Vascular / Q000188:drug therapy*; D018450:Disease Progression; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006949:Hyperlipidemias / Q000188:drug therapy; D006973:Hypertension / Q000188:drug therapy; D008559:Memantine / Q000627:therapeutic use; D020521:Stroke / Q000517:prevention & control
D000959:Antihypertensive Agents; D002800:Cholinesterase Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D001241:Aspirin; D008559:Memantine