Randomized controlled trials of primary and secondary prevention of vascular dementia demonstratereal effects on the cause or progression of disease (disease-modifying treatment). These strategieslead to a reduction in all cerebrovascular risk factors, in particular hypertension. Such treatmentmay prevent dementia by reducing stroke and possibly by other mechanisms that remain undetermined,such as those involved in neurodegeneration and cell death. Curative treatment of vasculardementia, particularly given recent studies on cholinesterase inhibitors (rivastigmine, donepezil andgalantamine) and memantine, is still ineffective. There is insufficient evidence to support widespreaduse of these drugs in vascular dementia. Particular considerations should be taken into account inclinical trials. Vascular dementia is a heterogeneous disease with different subtypes and mechanisms.Therefore, well-designed, adequately powered trials accounting for this heterogeneity, withbetter clinical definitions and an assessment and detection of cognitive and global changes specificto vascular dementia, are needed.
© 2009 S. Karger AG, Basel
Article / Publication Details
Published online: 1/26/2009
Cover Date: 2009
Number of Print Pages: 12
Number of Figures: 0
Number of Tables: 0
ISBN: 978-3-8055-9015-0 (Print)
eISBN: 978-3-8055-9016-7 (Online)
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