Neurological Manifestations of Vascular Dementia Medication

Updated: Nov 07, 2019
  • Author: Jasvinder Chawla, MD, MBA; Chief Editor: Niranjan N Singh, MBBS, MD, DM, FAHS, FAANEM  more...
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Medication Summary

No approved pharmacologic treatment exists for vascular dementia.

Risk factors for cerebrovascular disease should be treated when present.

Retrospective data indicate that normotensive patients with vascular dementia may have greater cognitive decline than hypertensive patients. This finding, as well as the known loss of cerebral blood flow autoregulation in chronic hypertension and cerebrovascular disease, should temper overenthusiastic attempts to normalize the blood pressure in patients with vascular dementia.

Treatment with antiplatelet agents may be initiated as indicated by the nature of the patient's underlying vascular pathology.

Cholinesterase inhibitors, which include donepezil, rivastigmine, and galantamine, have proven symptomatic efficacy in Alzheimer disease and may also have a role in the treatment of vascular dementia according to the findings of limited studies. Presently, their use may have some justification given the prevalence of dementia with mixed pathology.