An introduction to therapeutic approaches to vascular cognitive impairment

Vascular cognitive impairment (VCI), encompassing vascular dementia, has been claimed as the “second-most common dementia” after Alzheimer Disease. Whether or not this is true, the clinical picture of most dementia in older people includes vascular disease. There are no validated pharmacological tar...

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Autores principales:	Atticus H Hainsworth, Fanny M Elahi, Roderick A Corriveau
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Vascular cognitive impairment VCID Vascular dementia Treatments Clinical trials Drugs Specialties of internal medicine RC581-951 Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
Acceso en línea:	https://doaj.org/article/aef45284f30b42fd8664af5da18d87f1
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spelling	oai:doaj.org-article:aef45284f30b42fd8664af5da18d87f12021-11-18T04:51:49ZAn introduction to therapeutic approaches to vascular cognitive impairment2666-245010.1016/j.cccb.2021.100033https://doaj.org/article/aef45284f30b42fd8664af5da18d87f12021-01-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2666245021000301https://doaj.org/toc/2666-2450Vascular cognitive impairment (VCI), encompassing vascular dementia, has been claimed as the “second-most common dementia” after Alzheimer Disease. Whether or not this is true, the clinical picture of most dementia in older people includes vascular disease. There are no validated pharmacological targets for prevention or treatment of VCI. This has inspired a multitude of potential treatment approaches, reflected by the articles in this Special Issue. These include in vitro testing of the novel oral anticoagulant dabigatran for protection against β-amyloid neurotoxicity, and an overview of neuroinflammation in VCI and the role of circulating markers (PIGF, VEGF-D) identified by the MarkVCID study. There are reviews of potential therapeutics, including adrenomedullin and nootropic preparations (exemplified by cerebrolysin). The role of sleep is reviewed, with possible therapeutic targets (5HT2A receptors). There is a clinical study protocol (INVESTIGATE-SVD) and a feasibility analysis for a secondary prevention trial in small vessel disease. Clinical data include secondary analyses of blood pressure and cerebral blood flow from a longitudinal clinical trial (NILVAD), differences between methylphenidate and galantamine responders and non-responders (STREAM-VCI), appraisal of treatment approaches in India, and primary outcomes from a randomised trial of Argentine tango dancing to preserve cognition in African American women (ACT). Treating vascular disease has great potential to improve global cognitive health, with public health impacts alongside individual benefit. Vascular disease burden varies across populations, offering the possibility of proactively addressing health inequity in dementia using vascular interventions. The next 5–10 years will witness cost-effective lifestyle interventions, repurposed drugs and novel therapeutics.Atticus H HainsworthFanny M ElahiRoderick A CorriveauElsevierarticleVascular cognitive impairmentVCIDVascular dementiaTreatmentsClinical trialsDrugsSpecialties of internal medicineRC581-951Neurosciences. Biological psychiatry. NeuropsychiatryRC321-571ENCerebral Circulation, Cognition and Behavior, Vol 2, Iss , Pp 100033- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Vascular cognitive impairment VCID Vascular dementia Treatments Clinical trials Drugs Specialties of internal medicine RC581-951 Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571
spellingShingle	Vascular cognitive impairment VCID Vascular dementia Treatments Clinical trials Drugs Specialties of internal medicine RC581-951 Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Atticus H Hainsworth Fanny M Elahi Roderick A Corriveau An introduction to therapeutic approaches to vascular cognitive impairment
description	Vascular cognitive impairment (VCI), encompassing vascular dementia, has been claimed as the “second-most common dementia” after Alzheimer Disease. Whether or not this is true, the clinical picture of most dementia in older people includes vascular disease. There are no validated pharmacological targets for prevention or treatment of VCI. This has inspired a multitude of potential treatment approaches, reflected by the articles in this Special Issue. These include in vitro testing of the novel oral anticoagulant dabigatran for protection against β-amyloid neurotoxicity, and an overview of neuroinflammation in VCI and the role of circulating markers (PIGF, VEGF-D) identified by the MarkVCID study. There are reviews of potential therapeutics, including adrenomedullin and nootropic preparations (exemplified by cerebrolysin). The role of sleep is reviewed, with possible therapeutic targets (5HT2A receptors). There is a clinical study protocol (INVESTIGATE-SVD) and a feasibility analysis for a secondary prevention trial in small vessel disease. Clinical data include secondary analyses of blood pressure and cerebral blood flow from a longitudinal clinical trial (NILVAD), differences between methylphenidate and galantamine responders and non-responders (STREAM-VCI), appraisal of treatment approaches in India, and primary outcomes from a randomised trial of Argentine tango dancing to preserve cognition in African American women (ACT). Treating vascular disease has great potential to improve global cognitive health, with public health impacts alongside individual benefit. Vascular disease burden varies across populations, offering the possibility of proactively addressing health inequity in dementia using vascular interventions. The next 5–10 years will witness cost-effective lifestyle interventions, repurposed drugs and novel therapeutics.
format	article
author	Atticus H Hainsworth Fanny M Elahi Roderick A Corriveau
author_facet	Atticus H Hainsworth Fanny M Elahi Roderick A Corriveau
author_sort	Atticus H Hainsworth
title	An introduction to therapeutic approaches to vascular cognitive impairment
title_short	An introduction to therapeutic approaches to vascular cognitive impairment
title_full	An introduction to therapeutic approaches to vascular cognitive impairment
title_fullStr	An introduction to therapeutic approaches to vascular cognitive impairment
title_full_unstemmed	An introduction to therapeutic approaches to vascular cognitive impairment
title_sort	introduction to therapeutic approaches to vascular cognitive impairment
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/aef45284f30b42fd8664af5da18d87f1
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An introduction to therapeutic approaches to vascular cognitive impairment

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