Status of Treatment of Vascular Dementia

Lechner, H

doi:10.1159/000026148

Cited by 17 publications

(9 citation statements)

References 10 publications

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“…Regardless of the mechanisms of action, primary and secondary prevention of stroke and CVD appears to be mandatory for the prevention of dementia in the elderly [11, 12,86,87,88,89]. There are clear guidelines in stroke prevention for the use of anticoagulants [90], antiplatelet medication [91], as well as for control of nontraditional risk factors [13, 14].…”

Section: Treatment Of Risk Factors and Cognitive Outcomesmentioning

confidence: 99%

Vascular Dementia Prevention: A Risk Factor Analysis

Román¹

2005

Cerebrovasc Dis

132

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Brain injury from ischemic or hemorrhagic cerebrovascular disease (CVD) produces decline in cognitive functions and vascular dementia (VaD). Likewise, CVD may cause VaD from hypoperfusion of susceptible brain areas. CVD may also worsen degenerative dementias such as Alzheimer’s disease. Significant advances have been made in the identification and control of risk factors for stroke and cardiovascular disease. The main risk factors for VaD include age, hypertension and absence of antihypertensive medication, diabetes, cigarette smoking, history of cardiovascular disease (coronary heart disease, congestive heart failure, peripheral vascular disease), atrial fibrillation, left ventricular hypertrophy, hyperhomocysteinemia, orthostatic hypotension, cardiac arrhythmias, hyperfibrinogenemia, and sleep apnea. Recently identified risk factors include chronic infection and elevation of C-reactive protein, particularly in patients with diabetes. Evidence from controlled clinical trials strongly suggests that control of vascular risk factors, in particular hypertension, could prevent the development of dementia.

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Section: Treatment Of Risk Factors and Cognitive Outcomesmentioning

confidence: 99%

Vascular Dementia Prevention: A Risk Factor Analysis

Román¹

2005

Cerebrovasc Dis

132

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“…26 Vascular dementia (VaD), on the other hand, is more problematic as a nosologic entity. 3,[33][34][35] Cognitive impairment in VaD cases is directly correlated with blood pressure, age, and cardiovascular complications, and inversely correlated with education. [27][28][29][30][31] The Hachinski Ischemic Scale, still used today, related such elements as abrupt onset of dementia, stepwise deterioration, fluctuating course, history of strokes, and depression to multi-infarct dementia, which correlated with decreased blood flow.…”

mentioning

confidence: 99%

“…9,36 This tissue injury can be partly reversible, irreversible with cell death, or slowly progressive through spreading oxidative damage. 32,37,60,61 Treatment consists mostly of prevention of further strokes, control of hypertension, treatment of arteriosclerosis, 3,35,62 and trials of rehabilitation. Different authors have defined from four to eight different VaD subtypes, each with a distinct course.…”

mentioning

confidence: 99%

Vascular Dementia and Alzheimer's Disease: Is There a Difference?

Groves¹,

Brandt²,

Steinberg³

et al. 2000

JNP

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This study examined differences between vascular dementia (VaD) by the NINDS/AIRENS criteria and Alzheimer's disease (AD) on clinical grounds. A consecutive series of 517 patients with probable and possible VaD or AD were evaluated for cognitive, functional, and behavioral symptoms and separated into three subgroups by duration of dementia. These AD and VaD subgroups were then compared on a series of standardized clinical measures. The only consistent trends were for VaD patients to be more depressed, more functionally impaired, and less cognitively impaired within each disease duration subgroup. The authors conclude that there are few differences between clinically diagnosed VaD and AD. Subclassification of VaD into subgroups will improve the clinical utility of this nosologic entity.

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“…Control of high arterial blood pressure, cessation of smoking, and use of aspirin have been reported to improve or stabilize cognition [39][40][41]. It has been suggested that lowering plasma viscosity could also have an effect in VaD [42]. Effects of vitamins to reduce plasma homocysteine levels await results of randomized clinical trials [43].…”

Section: Other Treatment Optionsmentioning

confidence: 99%

Treatment of vascular dementia: Evidence from epidemiologic studies

Bae¹,

Pandey²

2005

Curr Treat Options Cardio Med

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This article discusses the most relevant recent evidence on the prevention and treatment of vascular dementia from epidemiologic studies. Vascular dementia is the most common form of dementia after Alzheimer's disease and remains the only one that is preventable, although most of our knowledge about primary and secondary prevention of vascular dementia comes from direct extrapolation from works in stroke. Furthermore, at present there are no approved therapeutic agents for the treatment of vascular dementia. Recently, however, a number of reasonable studies on vascular dementia have been available. It is clear that rigorous control of vascular risk factors is important in primary and secondary prevention of vascular dementia, and perhaps in ameliorating its mild form. A rational therapeutic approach to the treatment of vascular dementia should be based on an understanding of its broad clinical spectrum and the diverse causes that may be responsive to currently available treatments.

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Status of Treatment of Vascular Dementia

Cited by 17 publications

References 10 publications

Vascular Dementia Prevention: A Risk Factor Analysis

Vascular Dementia Prevention: A Risk Factor Analysis

Vascular Dementia and Alzheimer's Disease: Is There a Difference?

Treatment of vascular dementia: Evidence from epidemiologic studies

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