Medical Treatment and Therapy of Vascular Dementia

Therapies for vascular dementia is addressed to the cause, controlling risk factors (secondary prevention) and treatment of neuropsychiatric symptoms with regard to drug interactions. Other than that required multi-modality therapy for cognitive impairment and symptoms appropriate behavior.

Many drugs have been studied for the treatment of vascular dementia, but not many were successful and none of the positive drug can be recommended. Vasodilators such as hidergine have positive effects and orally active agent such pentoxiylline haemorheological able to improve their cognitive function of patients. Giving acetylcholineesterase inhibitors such as donepezil, rivastigmine and cognitive function galantiamin able meperbaiki penderita.Akhir these days is being investigated memantine for the treatment of vascular dementia. The effectiveness of memantine against vascular dementia investigated using a randomized design, double-blind, placebo controlled study which includes 321 patients in France and 579 patients in the UK. The results showed significant improvement in cognitive function in a group given memantine.
Research in the UK which includes 54 research centers conduct studies to assess the effectiveness and safety of memantine for patients with mild and moderate vascular dementia. The design of the study double-blind, parallel, randomized using the controls to enroll 579 patients. Doses of 20 mgdiberikan memantine daily for 28 weeks. Results showed that patients given memantine showed improvement in cognitive function. Adverse effects were seen were dizziness and show there is no significant difference between the two groups pelakuan. Apparently memantine is safe and acceptable to patients.

Vascular dementia can be prevented by addressing disease is a risk factor. There are several vascular dementia prevention strategies that can be done as follows:
1. Treat hypertension, optimally
2. Treating diabetes mellitus
3. Hyperlipidemia Tackle
4. Instruct patient to stop smoking and limit alcohol
5. Give anti-coagulants when atrial fibrillation
6. Give anti platelet aggregation in high-risk
7. Perform carotid endarterectomy in severe stenosis (> 70%)
8. Use diet to control diabetes, obesity, and hyperlipidemia
9. Encourage changing lifestyles (eg: reducing obesity, exercise, reduce stress, and reduce salt intake)
10. Early intervention in stroke and TIA with neuroprotective drugs (eg, propentofylline, calcium antagonists, N-methyl-D-aspartate receptor antagonists, antioxidants)
11. Provide intensive rehabilitation after stroke
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