Abstract
Vascular dementia (VAD), the second most common form of dementia after Alzheimers disease (AD) is characterized by a cognitive deficit of cerebrovascular origin. As for AD, the main proposed treatment is based on cholinesterase inhibitors. However, randomized clinical trials (RCTs) with cholinesterase inhibitors in VAD reported modest - though sometimes statistically significant - clinical efficacy. Non-cholinergic drugs with diverse rationales and mechanisms of action have also been tested in a few RCTs for VAD; the outcomes measured are variable and the evidence of efficacy is weak. The limitations of pharmacological treatment for VAD have prompted a different strategy, i.e. primary prevention aimed at reducing vascular risk factors. Several epidemiological studies reported associations of hypertension, type 2 diabetes, obesity, and inflammation with VAD and in some cases, AD. These all coincide with those of stroke, which in turn is an established factor for cognitive decline and VAD. Here too, only a few RCTs have looked at prevention of these factors, except hypertension. Some pharmacological classes are particularly promising from the clinical and experimental viewpoints: Ca2+ channel blockers and drugs affecting the renin-angiotensin system may act independently of the effects on blood pressure. Despite some conflicting results and the need for further work, the control of risk factors might prevent cognitive decline and VAD in the elderly. The benefit of tackling vascular factors is probably larger when also considering the prevention of stroke. The objective of this review is to analyze the pharmacological treatment and prevention of VAD and their outcome. The literature on Pubmed from 1980 to 2009 was examined.
Keywords: Vascular dementia, dementia, Alzheimer's disease, therapy, prevention, SIVD, AD therapy, Donepezil, Galantamine, Rivastigmine, Mematine, Ginkgo biloba extract, Piracetam, Dyslipidaemias, Metabolic syndrome
CNS & Neurological Disorders - Drug Targets
Title: Pharmacotherapy and Prevention of Vascular Dementia
Volume: 10 Issue: 3
Author(s): A. Moretti, A. Gorini and R. F. Villa
Affiliation:
Keywords: Vascular dementia, dementia, Alzheimer's disease, therapy, prevention, SIVD, AD therapy, Donepezil, Galantamine, Rivastigmine, Mematine, Ginkgo biloba extract, Piracetam, Dyslipidaemias, Metabolic syndrome
Abstract: Vascular dementia (VAD), the second most common form of dementia after Alzheimers disease (AD) is characterized by a cognitive deficit of cerebrovascular origin. As for AD, the main proposed treatment is based on cholinesterase inhibitors. However, randomized clinical trials (RCTs) with cholinesterase inhibitors in VAD reported modest - though sometimes statistically significant - clinical efficacy. Non-cholinergic drugs with diverse rationales and mechanisms of action have also been tested in a few RCTs for VAD; the outcomes measured are variable and the evidence of efficacy is weak. The limitations of pharmacological treatment for VAD have prompted a different strategy, i.e. primary prevention aimed at reducing vascular risk factors. Several epidemiological studies reported associations of hypertension, type 2 diabetes, obesity, and inflammation with VAD and in some cases, AD. These all coincide with those of stroke, which in turn is an established factor for cognitive decline and VAD. Here too, only a few RCTs have looked at prevention of these factors, except hypertension. Some pharmacological classes are particularly promising from the clinical and experimental viewpoints: Ca2+ channel blockers and drugs affecting the renin-angiotensin system may act independently of the effects on blood pressure. Despite some conflicting results and the need for further work, the control of risk factors might prevent cognitive decline and VAD in the elderly. The benefit of tackling vascular factors is probably larger when also considering the prevention of stroke. The objective of this review is to analyze the pharmacological treatment and prevention of VAD and their outcome. The literature on Pubmed from 1980 to 2009 was examined.
Export Options
About this article
Cite this article as:
Moretti A., Gorini A. and F. Villa R., Pharmacotherapy and Prevention of Vascular Dementia, CNS & Neurological Disorders - Drug Targets 2011; 10 (3) . https://dx.doi.org/10.2174/187152711794653832
DOI https://dx.doi.org/10.2174/187152711794653832 |
Print ISSN 1871-5273 |
Publisher Name Bentham Science Publisher |
Online ISSN 1996-3181 |
Call for Papers in Thematic Issues
Novel Treatments in Subarachnoid Hemorrhage
The current landscape of therapeutic strategies for subarachnoid hemorrhage (SAH), a significant adverse neurological event commonly resulting from the rupture of intracranial aneurysms, is rapidly evolving. Through an in-depth exploration of the natural history of SAH, historical treatment approaches, and emerging management modalities, the present work aims to provide a ...read more
Pathogenic Proteins in Neurodegenerative Diseases: From Mechanisms to Treatment Modalities
The primary objective of this thematic issue is to elucidate the molecular mechanisms by which pathogenic proteins contribute to neurodegenerative diseases and to highlight current and emerging therapeutic strategies aimed at mitigating their effects. By bringing together cutting-edge research and reviews, this issue aims to: 1.Enhance Understanding: Provide a comprehensive ...read more
Role of glial cells in autism spectrum disorder: Molecular mechanism and therapeutic approaches
Emerging evidence suggests that glial cells may play a pivotal role in neuroanatomical and behavioral changes found in autism spectrum disorder (ASD). Many individuals with ASD experience a neuro-immune system abnormalities throughout life, which implicates a potential role of microglia in the pathogenesis of ASD. Dysfunctional astrocytes and oligodendrocytes were ...read more
Trends and perspectives in the rational management of CNS disorders
Central nervous system (CNS) diseases enforce a significant global health burden, driving ongoing efforts to improve our understanding and effectiveness of therapy. This issue investigates current advances in the discipline, focusing on the understanding as well as therapeutic handling of various CNS diseases. The issue covers a variety of diseases, ...read more
![](/images/wayfinder.jpg)
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
The Molecular Basis of Conantokin Antagonism of NMDA Receptor Function
Current Drug Targets The Role of Autophagy in the Pathogenesis of Ischemic Stroke
Current Neuropharmacology Ipsilateral Hippocampal Proteomics Reveals Mitochondrial Antioxidative Stress Impairment in Cortical-Lesioned Chronic Mild Stressed Rats
Current Molecular Medicine The Role of Advanced Technologies Supplemented with Traditional Methods in Pharmacovigilance Sciences
Recent Patents on Biotechnology A Multicentre Italian Validation Study in Aging Adults with Down Syndrome and Other Forms of Intellectual Disabilities: Dementia Screening Questionnaire for Individuals with Intellectual Disabilities
Current Alzheimer Research The Cellular Protective Effects of Rosmarinic Acid: From Bench to Bedside
Current Neurovascular Research Hypertension in Pregnancy: Pathophysiology & Management Strategies
Current Pharmaceutical Design Development of Computer-AidedCognitive Training Program for Elderly and Its Effectivenessthrougha 6 Months Group Intervention Study
Current Alzheimer Research Aggresome Formation and Neurodegenerative Diseases: Therapeutic Implications
Current Medicinal Chemistry Niacin Status, NAD Distribution and ADP-Ribose Metabolism
Current Pharmaceutical Design Oestrogen-A Protective Factor in Schizophrenia?
Current Psychiatry Reviews A Novel Relationship for Schizophrenia, Bipolar and Major Depressive Disorder Part 6: A Hint from Chromosome 6 High Density Association Screen
Current Molecular Medicine HIV-1-Associated Dementia During HAART Therapy
Recent Patents on CNS Drug Discovery (Discontinued) Selectivity Problems with Drugs Acting on Cardiac Na<sup>+</sup> and Ca<sup>2+</sup> Channels
Current Medicinal Chemistry Biologic Therapy in Psoriasis: Safety Profile
Current Drug Safety Hyperhomocysteinemia and Cardiovascular Risk: Effect of Vitamin Supplementation in Risk Reduction
Current Clinical Pharmacology Evolution of Global and Local Grey Matter Atrophy on Serial MRI Scans During the Progression from MCI to AD
Current Alzheimer Research Abnormal Clock Gene Expression and Locomotor Activity Rhythms in Two Month-Old Female APPSwe/PS1dE9 Mice
Current Alzheimer Research Translational Challenge Models in Support of Efficacy Studies: Effect of Cerebral Hypoxia on Cognitive Performances in Rodents
CNS & Neurological Disorders - Drug Targets Assessment of Persistent, Bioaccumulative and Toxic Organic Environmental Pollutants in Liver and Adipose Tissue of Alzheimer’s Disease Patients and Age-matched Controls
Current Alzheimer Research