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Vascular Dementia - Prevention And Treatment Of Vascular Dementia

aging clinical disease hachinski journal erkinjuntti

Primary prevention aims to reduce the incidence of a disease by eliminating its causes or main risk factors. In VaD dementia the targets are CVD, including arterial hypertension, atrial fibrillation, myocardial infarction, coronary heart disease, diabetes, generalized atherosclerosis, lipid abnormalities and smoking. In addition, the use of estrogen, anti-inflammatory agents and antioxidants appear to reduce the risk of VaD.

Secondary prevention aims to prevent established disease from progressing. It emphasizes early detection and treatment. Treatment is aimed at treating the underlying cause, such as large artery disease (e.g., aspirin, dipyridamole, clopidragril, carotid endarterectomy), cardiac embolic events (e.g. anticoagulation, spirin), small-vessel disease (e.g. antiplatelet therapy as in large vessel disease), and hemodynamic mechanisms (e.g. control of hypotension and cardiac arrythmias).

How well all this works still is unclear. While a considerable degree of progress in our understanding of vascular dementia has been made, it is clear that much needs to be done before we will have effective treatment of this common and disabling problem.



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