Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-78c5997874-fbnjt Total loading time: 0 Render date: 2024-11-10T12:34:50.407Z Has data issue: false hasContentIssue false

15 - Treatment of cognitive changes

from Section 3 - Treatment

Published online by Cambridge University Press:  15 September 2009

By
Serge Gauthier  and
Timo Erkinjuntti
Edited by
Lars-Olof Wahlund ,
Timo Erkinjuntti  and
Serge Gauthier
Lars-Olof Wahlund
Affiliation:
Karolinska Institutet, Stockholm
Timo Erkinjuntti
Affiliation:
University of Helsinki
Serge Gauthier
Affiliation:
McGill University, Montréal
Get access

Summary

This chapter reviews available evidence for a cognitive improvement associated with cholinesterase inhibitors (ChEI) and memantine in vascular dementia (VaD) and Alzheimer's disease (AD) with cerebrovascular disease (CVD). It discusses cognitive changes associated with the dementia stage of VaD. A cholinergic deficit has been demonstrated in VaD, independently of any concomitant AD pathology. Cholinergic structures are vulnerable to ischemic damage. Donepezil and rivastigmine have been studied using randomized clinical trials in VaD and galantamine in a mixed population of VaD and AD with CVD. Sub-group analyses by radiological findings at baseline showed that the cognitive treatment effect for memantine was more pronounced in the small-vessel type group without cortical infarctions by computed tomography (CT) or magnetic resonance imaging (MRI). Cognitive tests should be performed before treatment, preferable using those with an executive component, to be repeated at set intervals in the order of six months.

Keywords

Alzheimer's diseasebeta amyloid markersblood-brain barrier breakdowncerebrospinal fluidinflammation markersvascular dementiavascular diseaseglial activation markers
Type
Chapter
Information
Vascular Cognitive Impairment in Clinical Practice , pp. 195 - 199
Publisher: Cambridge University Press
Print publication year: 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×