Use of antidementia agents in vascular dementia: beyond Alzheimer disease

Area of Science:

• Neurology
• Gerontology
• Pharmacology

Background:

• Vascular dementia (VaD) is the second most common cause of dementia, frequently underdiagnosed.
• Stroke is the primary cause of VaD, but other cerebrovascular and cardiovascular conditions can also contribute.
• Currently, no specific drugs are FDA-approved for treating VaD.

Purpose of the Study:

• To explore the potential therapeutic benefits of existing Alzheimer's disease (AD) medications for Vascular Dementia (VaD).
• To review evidence supporting the use of cholinesterase inhibitors and N-methyl-D-aspartate receptor antagonists in VaD treatment.

Main Methods:

• Review of clinical trials and existing literature on antidementia drugs in VaD.
• Analysis of studies investigating cholinesterase inhibitors (donepezil, galantamine, rivastigmine) and memantine in VaD patients.
• Focus on large-scale, prospective studies, particularly for donepezil.

Main Results:

• Clinical trials suggest cholinesterase inhibitors may benefit VaD patients, mirroring findings in Alzheimer's disease (AD).
• Donepezil demonstrated significant improvements in cognition, global function, and daily living activities compared to placebo in VaD.
• Memantine, an N-methyl-D-aspartate receptor antagonist, may offer cognitive benefits, especially in advanced VaD stages.

Conclusions:

• Antidementia drugs approved for AD, such as cholinesterase inhibitors and memantine, should be considered for treating VaD.
• Further large-scale studies are warranted, but current data support exploring these AD treatments for VaD management.