title: [Effect of AChE and BuChE inhibition by rivastigmin in a group of old-old elderly patients with cerebrovascular impairment (SIVD type)].
abstract: OBJECTIVE
  Vascular dementia (VaD) is defined as a loss of cognitive function resulting from ischemic, hypoperfusive, or hemorrhagic brain lesions due to cerebrovascular disease or cardiovascular pathology. The main types of VaD are: Small Vessel Disease Dementia (sVAD), Large vessel disease dementia, hypoperfusive-ischemic dementia and hemorragic dementia. The sVAD is divided into two main categories: subcortical ischemic vascular dementia (SIVD) and cortical dementia. Currently, no drugs are approved for the treatment of VaD. This study aimed to determine whether rivastigmine, a second generation cholinesterase inhibitor with selectivity for the CNS, with capacity to inhibit both acetylcholinesterase (AChE) and butyryl-cholinesterase (BuChE), slows the rate of cognitive decline associated with VaD.
  
  
  METHODS
  Study subjects were 27 male and 43 female outpatients aged 80.03±6.53 years, with Mini-Mental State Examination (MMSE) score ranging batween 22 and 12, affected by VaD. They were included in the study if they were undergoing pharmacological treatment with acetylsalicylic acid 100 mg for at least six months. Patients were divided into two groups: one group was treated with ASA 100 mg and rivastigmine patch 9.5 mg (Rivastigmine group), the other just with ASA 100 mg (ASA group). All patients were followed for 6 months, with a first evaluation (T0) and a second examination after six mounths of treatment (T1).
  
  
  RESULTS
  Statistically data proved as the Rivastigmine group showed constant values at MMSE, compared with patients of the ASA group who experienced decline of their cognitive performances. The same result was found in CDR, ADL, GDS and NPI scales. It is remarkable to underline as Rivastigmine-treated patients had a mean improvement in GDS scales, in comparison with patients of the ASA group who showed a worsening of mood.
  
  
  CONCLUSIONS
  Rivastigmine-therapy improves cognitive performance in elderly with SIVD.
authors.affiliation: Dipartimento di Sanità Pubblica e Malattie Infettiva La Sapienza Università di Roma, Roma, Italia - adriana.servello@uniroma1.it.
authors.forename: A
authors.initials: A
authors.lastname: Servello
authors.forename: P
authors.initials: P
authors.lastname: Andreozzi
authors.forename: F
authors.initials: F
authors.lastname: Bechini
authors.forename: R
authors.initials: R
authors.lastname: De Angelis
authors.forename: M L
authors.initials: ML
authors.lastname: Pontecorvo
authors.forename: A
authors.initials: A
authors.lastname: Vulcano
authors.forename: E
authors.initials: E
authors.lastname: Cerra
authors.forename: M T
authors.initials: MT
authors.lastname: Vigliotta
authors.forename: M
authors.initials: M
authors.lastname: Artini
authors.forename: L
authors.initials: L
authors.lastname: Selan
authors.forename: E
authors.initials: E
authors.lastname: Ettorre
mesh_terms: D000110:Acetylcholinesterase; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002091:Butyrylcholinesterase; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D003071:Cognition / Q000187:drug effects*; D015140:Dementia, Vascular / Q000145:classification / Q000188:drug therapy*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D048448:Phenylcarbamates / Q000627:therapeutic use*; D000068836:Rivastigmine
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D002800:Cholinesterase Inhibitors; D018696:Neuroprotective Agents; D048448:Phenylcarbamates; D000110:Acetylcholinesterase; D002091:Butyrylcholinesterase; D000068836:Rivastigmine; D001241:Aspirin