Therapeutic Strategies and Drug Development for Vascular Cognitive Impairment

Smith, Eric E.; Cieślak, Alicja; Barber, Philip A.; Chen, Jerry; Chen, Yu Wei; Donnini, Ida; Edwards, Jodi D.; Frayne, Richard; Field, Thalia S.; Hegedus, Janka; Hanganu, Victoria; Ismail, Zahinoor; Kanji, Jamila; Nakajima, Makoto; Noor, Raza; Peca, Stefano; Sahlas, Demetrios J.; Sharma, Mukul; Sposato, Luciano A.; Swartz, Richard H.; Zerna, Charlotte; Black, Sandra E.; Hachinski, Vladimir

doi:10.1161/jaha.117.005568

Cited by 47 publications

(40 citation statements)

References 74 publications

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“…10 Here we provide recommendations for neuroimaging, ,11 prevention, 12 and management of stroke and stroke risk factors including hypertension, 13,14 and pharmacological management of VCI (Table 2). 15…”

Section: Diagnosis and Treatment Of Vcimentioning

confidence: 99%

Recommendations of the 5th Canadian Consensus Conference on the diagnosis and treatment of dementia

Ismail

Black

Camicioli

et al. 2020

Alzheimer's & Dementia

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158

171

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Since 1989, four Canadian Consensus Conferences on the Diagnosis and Treatment of Dementia (CCCDTD) have provided evidence‐based dementia guidelines for Canadian clinicians and researchers. We present the results of the 5th CCCDTD, which convened in October 2019, to address topics chosen by the steering committee to reflect advances in the field, and build on previous guidelines. Topics included: (1) utility of the National Institute on Aging research framework for clinical Alzheimer's disease (AD) diagnosis; (2) updating diagnostic criteria for vascular cognitive impairment, and its management; (3) dementia case finding and detection; (4) neuroimaging and fluid biomarkers in diagnosis; (5) use of non‐cognitive markers of dementia for better dementia detection; (6) risk reduction/prevention; (7) psychosocial and non‐pharmacological interventions; and (8) deprescription of medications used to treat dementia. We hope the guidelines are useful for clinicians, researchers, policy makers, and the lay public, to inform a current and evidence‐based approach to dementia.

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Section: Diagnosis and Treatment Of Vcimentioning

confidence: 99%

Recommendations of the 5th Canadian Consensus Conference on the diagnosis and treatment of dementia

Ismail

Black

Camicioli

et al. 2020

Alzheimer's & Dementia

Self Cite

158

171

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“…50 Trials for treating vascular dementia have recently been systematically reviewed. 51 Interventions included vasodilators, antithrombotic medications, and neuroprotectants. 51 However, none of the reviewed trials reported whether these interventions prevented new brain infarcts.…”

Section: Clinical Trials Of Cbi Preventionmentioning

confidence: 99%

Preventing Covert Brain Infarct-Related Cognitive Impairment and Dementia

Durrani

Hill

Smith

2020

Can. J. Neurol. Sci.

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Covert brain infarcts (CBIs) are five times more prevalent than symptomatic brain infarcts. CBIs are associated with cognitive impairment and therefore may be a target for preventing cognitive decline and dementia. This review focuses on strategies for preventing CBI-related cognitive impairment, either by preventing incident or recurrent CBI or by enhancing cognitive reserve. CBIs begin to become prevalent during midlife and are highly prevalent in later life. The distribution of vascular pathologies of CBI differs from those that cause symptomatic stroke; therefore, preventive treatments may need to differ as well. Only a few randomized clinical trials have provided data on CBI prevention, without conclusive results. Limited data suggest that higher early-life education, hypothesized to enhance cognitive reserve, can protect the brain from effects of CBI.

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“…However, none have received regulatory approval particularly because the lower effect sizes compared to AD. Considered the previous aspects, the main drugs are briefly reviewed [216]. …”

Section: Pharmacological Treatmentmentioning

confidence: 99%

Latin American Delphi Consensus on Vascular Cognitive Impairment: Definitions, Clinical Features, Pathophysiology, Prevention and Treatment

Alvarado¹,

Brito²,

Román³

et al. 2017

J Neurol Neurosci

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Cerebral vascular disease (CVD) represents the second cause in years of life lost, according to the Global Burden of Disease Study 2015 study. The global report on Alzheimer's disease 2015 estimates that in Latin America there are 9.2 million cases of dementia, with a prevalence of 8.2%. Undoubtedly, Alzheimer's disease is the most frequent cause, followed by vascular dementia (VD) with 15% of the cases, although global data are unknown in Latin America. Objective:To analyze and present the current evidence on the classification, pathophysiology, diagnosis and treatment of vascular cognitive impairment. Methodology:A group of experts met in Miami, Florida, in April 2016. The group included Neurologists, Geriatricians and Psychiatrists from the following countries: Mexico, Guatemala, El Salvador, Costa Rica, Peru, Spain, Bolivia, Chile, Paraguay, Colombia, Panama, Venezuela, Italy, the United States, Dominican Republic, Honduras and Nicaragua. The Delphi method was used to review available information (provided months before the meeting), in relation to assigned topics: definition of Cognitive Vascular Impairment (CVI), risk factors, pathophysiology, diagnosis (neuropsychological and imaging) and treatment. For the allocation of evidence and recommendation of available treatments, the GRADE system was used.The working groups analyzed and discussed available evidence on CVI concerning proposed definitions, risk factors and diagnostic elements. Subsequently, the conclusions of each of the working groups were drafted, which were reviewed by each of the authors and by the rest of the study groups until a global consensus was reached. Once this process was completed, the process of external validation and preparation of the final document was carried out.The results of this consensus allow the incorporation of the opinion and experience of physicians of different specialties in Latin America regarding the vascular cognitive impairment.

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Therapeutic Strategies and Drug Development for Vascular Cognitive Impairment

Cited by 47 publications

References 74 publications

Recommendations of the 5th Canadian Consensus Conference on the diagnosis and treatment of dementia

Recommendations of the 5th Canadian Consensus Conference on the diagnosis and treatment of dementia

Preventing Covert Brain Infarct-Related Cognitive Impairment and Dementia

Latin American Delphi Consensus on Vascular Cognitive Impairment: Definitions, Clinical Features, Pathophysiology, Prevention and Treatment

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