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Pharmacotherapy for Vascular Cognitive Impairment

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Abstract

Vascular cognitive impairment (VCI) is the second most common type of dementia after Alzheimer’s disease (AD). Stroke and cardiovascular risk factors have been linked to both AD and VCI and potentially can affect cognitive function in mid and later life. Various pharmacological agents, including donepezil, galantamine, and memantine, approved for the treatment of AD have shown modest cognitive benefits in patients with vascular dementia (VaD). However, their functional and global benefits have been inconsistent. Donepezil has shown some cognitive benefit in patients with VaD only, and galantamine has shown some benefit in mixed dementia (AD/VaD). The benefits of other drugs such as rivastigmine, memantine, nimodipine, and piracetam are not clear. Some other supplements and herbal therapies, such as citicoline, actovegin, huperzine A, and vinpocetine, have also been studied in patients with VaD, but their beneficial effects are not well established. Non-drug therapies and lifestyle modifications such as diet, exercise, and vascular risk factor control are important in the management of VCI and should not be ignored. However, there is a need for more robust clinical trials focusing on executive function and other cognitive measures and incorporation of newer imaging modalities to provide additional evidence about the utility of these strategies in patients with VCI.

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References

  1. Hachinski V. Stroke and potentially preventable dementias proclamation. Stroke. 2015;46:2723–4.

    Article  Google Scholar 

  2. Gorelick PB. World stroke day proclamation 2015. Call to preserve cognitive vitality. Stroke. 2015;46:3037–8.

    Article  PubMed  Google Scholar 

  3. Gorelick PB, Scuteri A, Black SE, Decarli C, Greenberg SM, Iadecola C, et al. Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2011;42:2672–27113.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Gorelick PB, Nyenhuis D. Understanding and treating vascular cognitive impairment. CONTINUUM (Minneap Minn). 2013;19(2):425–37.

    Google Scholar 

  5. Sachdev P, Kalaria R, O’Brien J, et al. Diagnostic criteria for vascular cognitive disorders: a VASCOG statement. Alzheimer Dis Assoc Disord. 2014;28(3):206–18.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: American Psychiatric Association; 2013.

    Book  Google Scholar 

  7. Gorelick PB, Erkinjuntti T, Hofman A, Rocca WA, Skoog I, Winblad B. Prevention of vascular dementia. Alzheimer Dis Assoc Disord. 1999;13(Suppl 3):S131–9.

    PubMed  Google Scholar 

  8. Casserly I, Topol E. Convergence of atherosclerosis and Alzheimer’s disease: inflammation, cholesterol, and misfolded proteins. Lancet. 2004;363:1139–46.

    Article  CAS  PubMed  Google Scholar 

  9. Gorelick PB. William feinberg lecture: cognitive vitality and the role of stroke and cardiovascular disease risk factors. Stroke. 2005;36:875–9.

    Article  PubMed  Google Scholar 

  10. Barnes DE, Yaffe K. The projected effect of risk factor reduction on Alzheimer’s disease prevalence. Lancet Neurol. 2011;10:819–28.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Gorelick PB, Counts S, Nyenhuis D. Vascular cognitive impairment and dementia. Vascular cognitive impairment and dementia. Biochim Biophys Acta. 2016;1862(5):860–8. doi:10.1016/j.bbadis.2015.12.015.

    Article  CAS  PubMed  Google Scholar 

  12. Jaggar C, Matthews FE, Wohland P, Fouweather T, Stephan BCM, Robinson L, et al. A comparison of health expectancies over two decades in England: results of the Cognitive Function and Ageing Study I and II. Lancet. 2016;387:779–86.

    Article  Google Scholar 

  13. Satizabal CL, Beiser AS, Chouraki V, Chene G, Dufoil C, Seshadri S. Incidence of dementia over three decades in the Framingham Heart Study. N Engl J Med. 2016;374:323.

    Article  Google Scholar 

  14. Larson EB, Yaffe K, Langa KM. New insights into the dementia epidemic. N Engl J Med. 2013;369:2275–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Yaffe K, Vittinghoff E, Pletcher MJ, Hoang TD, Launer LJ, Whitmer RA, Coker LH, Sidney S. Early adult to midlife cardiovascular risk factors and cognitive function. Circulation. 2014;129:1560–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Iadecola C, Yaffe K, Biller J, Bratzke LC, Faraci FM, Gorelick PB, et al. Impact of hypertension on cognitive function. A scientific statement from the American Heart Association. Hypertension. 2016;68(6):e67–94. doi:10.1161/HYP.0000000000000053.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Andrieu S, Coley N, Lovestone S, Aisen PS, Vellas B. Prevention of sporadic Alzheimer’s disease: lessons learned from clinical trials and future directions. Lancet Neurol. 2015;14:926–44.

    Article  PubMed  Google Scholar 

  18. Institute of Medicine Brief Report. Cognitive aging: progress in understanding and opportunities for action, April 2015. http://www.iom.edu/cognitiveaging. Accessed 1 May 2017.

  19. Daviglus ML, Plassman BL, Pirzada A, Bell CC, Bowen PE, Burke JR, et al. Risk factors and preventive interventions for Alzheimer disease: state of the science. Arch Neurol. 2011;68:1185–90.

    Article  PubMed  Google Scholar 

  20. Haba-Rubio J, Marti-Soler H, Tobback N, Andries D, et al. Sleep characteristics and cognitive impairment in the general population: the HypnoLaus study. Neurology. 2017;88:463–9.

    Article  PubMed  Google Scholar 

  21. Pantoni L, Gorelick PB, editors. Cerebral small vessel disease. Cambridge: Cambridge University Press; 2014. p. 1–360.

    Book  Google Scholar 

  22. Rosenberg GA, Wallin A, Wardlaw JM, Markus HS, Montaner J, Wolfson L, et al. Consensus statement for diagnosis of subcortical small vessel disease. J Cereb Blood Flow Metab. 2016;36(1):6–25.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Hachinski V. Stroke and Alzheimer disease. Fellow travelers or partners in crime? Arch Neurol. 2011;68(6):797–8.

    Article  PubMed  Google Scholar 

  24. Hachinski V, Sposato LA. Dementia: from muddled diagnoses to treatable mechanisms. Brain. 2013;136:2652–6.

    Article  PubMed  Google Scholar 

  25. Gorelick PB, Mangone CA. Vascular dementias in the elderly. Clin Geriatr Med. 1991;7(3):599–615.

    CAS  PubMed  Google Scholar 

  26. Roman GC, Tatemichi TK, Erkinjuntti T, Cummings JL, Masdeu JC, Garcia JH, et al. Vascular dementia diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology. 1993;43:250–60.

    Article  CAS  PubMed  Google Scholar 

  27. Chui HC, Victoroff JI, Margolin D, Jagust W, Shankle R, Katzman R. Criteria for the diagnosis of ischemic vascular dementia proposed by the State of California Alzheimer’s Disease Diagnostic and Treatment Centers. Neurology. 1992;42:473–80.

    Article  CAS  PubMed  Google Scholar 

  28. Smith E. Vascular cognitive impairment. CONTINUUM (Minneap Minn). 2016;22(2):490–509.

    Google Scholar 

  29. Skrobot OA, O’Brien J, Black S, Chen C, et al. VICCCS group. The Vascular Impairment of Cognition Classification Consensus Study. Alzheimers Dement. 2017;13:624–33. doi:10.1016/j.jalz.2016.10.007.

    Article  PubMed  Google Scholar 

  30. Kotagal V, Langa KM, Plassman BL, Fisher GG, Girodani BJ, Wallace RB, et al. Factors associated with cognitive evaluations in the United States. Neurology. 2015;84:64–71.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Lin JS, O’Connor E, Rossom RC, et al. Screening for cognitive impairment in older adults: An evidence Update for the US Preventive Services Task Force. Rockville: US Agency for Healthcare Research and Quality; 2013.

    Google Scholar 

  32. Gold G, Giannakopoulos P, Montes-Paixao C Jr, Hermann FR, Mulligan R, Michel JP, Bouras C. Sensitivity and specificity of newly proposed clinical criteria for possible vascular dementia. Neurology. 1997;49:690–4.

    Article  CAS  PubMed  Google Scholar 

  33. Erkinjuntti T, Ostbye T, Steenhuis R, Hachinski V. The effect of different diagnostic criteria on the prevalence of dementia. N Engl J Med. 1997;337:1667–74.

    Article  CAS  PubMed  Google Scholar 

  34. Barclay LL, Zemcov A, Blass FP, et al. Survival in Alzheimer’s disease and vascular dementia. Neurology. 1985;35:834–40.

    Article  CAS  PubMed  Google Scholar 

  35. Hier DB, Warach J, Gorelick PB, et al. Predictors of survival in clinically diagnosed Alzheimer’s disease and multi-infarct dementia. Arch Neurol. 1989;46:1213–6.

    Article  CAS  PubMed  Google Scholar 

  36. Martin DC, Miller JK, Kapoor W, et al. A controlled study of survival with dementia. Arch Neurol. 1987;44:1122–6.

    Article  CAS  PubMed  Google Scholar 

  37. Molsa PK, Martilla RJ, Rinne UK. Survival and cause of death in Alzheimer’s disease and multi-infarct dementia. Acta Neurol Scand. 1986;74:103–7.

    Article  CAS  PubMed  Google Scholar 

  38. Freels S, Nyenhuis DL, Gorelick PB. Predictors of survival in African-American patients with AD, VaD, or stroke without dementia. Neurology. 2002;59:1146–53.

    Article  PubMed  Google Scholar 

  39. Gorelick PB. Blood pressure and the prevention of cognitive impairment. JAMA Neurol. 2014;71:1211–3. doi:10.1001/jamaneurol.2014.2014.

    Article  PubMed  Google Scholar 

  40. Chamandy N, Wolfson C. Underlying cause of death to demented and non-demented elderly Canandians. Neuroepidemiology. 2005;25:75–84.

    Article  PubMed  Google Scholar 

  41. Knopman DS, Rocca WA, Cha RH, Edland SD, Kokmen E. Survival study of vascular dementia in Rochester, Minnesota. Arch Neurol. 2003;60:85–90.

    Article  PubMed  Google Scholar 

  42. Barba R, Morin MdM, Cemillian C, Delgado CD, Domingo J, Del Ser T. Previous and incident dementia as risk factors for mortality in stroke patients. Stroke. 2002;33:1993–8.

    Article  PubMed  Google Scholar 

  43. Desmond DW, Moroney JT, Sano M, Stern Y. Mortality in patients with dementia after ischemic stroke. Neurology. 2002;59:537–43.

    Article  PubMed  Google Scholar 

  44. Ostbye T, Hill G, Steenhuis R. Mortality in elderly Canadians with and without dementia. A 5-year follow-up. Neurology. 1999;53:521–6.

    Article  CAS  PubMed  Google Scholar 

  45. Hachinski V, Iadecola C, Petersen RC, Breteler MN, Nyenhuis DL, Black SE, et al. National Institute of Neurological Disorders and Stroke-Canadian Stroke Network vascular cognitive impairment harmonization standards. Stroke. 2006;37:2220–41.

    Article  PubMed  Google Scholar 

  46. Nyenhuis DL, Gorelick PB, Freels S, Garron DC. Cognitive and functional decline in African Americans with VaD, AD, and stroke without dementia. Neurology. 2002;58:56–61.

    Article  PubMed  Google Scholar 

  47. Nyenhuis DL, Gorelick PB, Geenen EJ, Smith CA, Gencheva E, Freels S, deToledo-Morrell L. The pattern of neuropsychological deficits in vascular cognitive impairment-no dementia (Vascular CIND). Clin Neuropsychol. 2004;18(1):41–9.

    Article  PubMed  Google Scholar 

  48. Meyer JS, Xu G, Thornby J, Chowdhury MH, Quach M. Is mild cognitive impairment prodromal for vascular dementia like Alzheimer’s disease? Stroke. 2002;33:1981–5.

    Article  PubMed  Google Scholar 

  49. Wentzel C, Rockwood K, MacKnight C, Hachinski V, Hogan DB, Feldman H, et al. Progression of impairment in patients with vascular cognitive impairment without dementia. Neurology. 2001;57:714–6.

    Article  CAS  PubMed  Google Scholar 

  50. Ingles JL, Wentzel C, Fisk JD, Rockwood K. Neuropsychological predictors of incident dementia in patients with vascular cognitive impairment, without dementia. Stroke. 2002;33:1999–2002.

    Article  PubMed  Google Scholar 

  51. Gottfries CG, Blennow K, Karlsson I, Willin A. The neurochemistry of vascular dementia. Dementia. 1994;5:163–7.

    CAS  PubMed  Google Scholar 

  52. Grantham C, Geerts H. The rationale behind cholinergic drug treatment for dementia related to cerebrovascular disease. J Neurol Sci. 2002;203–204:131–6.

    Article  PubMed  Google Scholar 

  53. Mesulam M, Siddiqe T, Cohen B. Cholinergic denervation in a pure multi-infarct state: observations on CADASIL. Neurology. 2003;60:1183–5.

    Article  PubMed  Google Scholar 

  54. Wilkinson D, Doody R, Helme R, Taubman K, Mintzer J, Kertesz A, Pratt RD, Donepezil 308 Study Group. Donepezil in vascular dementia: a randomized, placebo-controlled study. Neurology. 2003;61:479–86.

    Article  CAS  PubMed  Google Scholar 

  55. Black S, Román GC, Geldmacher DS, Salloway S, Hecker J, Burns A, Perdomo C, Kumar D, Pratt R, Donepezil 307 Vascular Dementia Study Group. Efficacy and tolerability of donepezil in vascular dementia: positive results of a 24-week, multicenter, international, randomized, placebo-controlled clinical trial. Stroke. 2003;34:2323–30.

    Article  CAS  PubMed  Google Scholar 

  56. Román GC, Wilkinson DG, Doody RS, Black SE, Salloway SP, Schindler RJ. Donepezil in vascular dementia: combined analysis of two large-scale clinical trials. Dement Geriatr Cogn Disord. 2005;20:338–44.

    Article  PubMed  Google Scholar 

  57. Román GC, Salloway S, Black SE, Royall DR, Decarli C, Weiner MW, Moline M, Kumar D, Schindler R, Posner H. Randomized, placebo-controlled, clinical trial of donepezil in vascular dementia: differential effects by hippocampal size. Stroke. 2010;41:1213–21.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Dichgans M, Markus HS, Salloway S, Verkkoniemi A, Moline M, Wang Q, Posner H, Chabriat HS. Donepezil in patients with subcortical vascular cognitive impairment: a randomised double-blind trial in CADASIL. Lancet Neurol. 2008;7:310–8.

    Article  CAS  PubMed  Google Scholar 

  59. Maelicke A, Albuquerque EX. Allosteric modulation of nicotinic acetylcholine receptors as a treatment strategy for Alzheimer’s disease. Eur J Pharmacol. 2000;393:165–70.

    Article  CAS  PubMed  Google Scholar 

  60. Craig D, Birks J. Galantamine for vascular cognitive impairment. Cochrane Database Syst Rev. 2006;1:CD004746.

    Google Scholar 

  61. Erkinjuntti T, Kurz A, Gauthier S, Bullock R, Lilienfeld S, Damaraju CV. Efficacy of galantamine in probable vascular dementia and Alzheimer’s disease combined with cerebrovascular disease: a randomised trial. Lancet. 2002;359:1283–90.

    Article  PubMed  Google Scholar 

  62. Auchus AP, Brashear HR, Salloway S, Korczyn AD, De Deyn PP, Gassmann-Mayer C, GAL-INT-26 Study Group. Galantamine treatment of vascular dementia: a randomized trial. Neurology. 2007;69:448–58.

    Article  CAS  PubMed  Google Scholar 

  63. Craig D, Birks J. Rivastigmine for vascular cognitive impairment. Cochrane Database Syst Rev. 2005;2:CD004744.

    Google Scholar 

  64. Narasimhalu K, Effendy S, Sim CH, Lee JM, Chen I, Hia SB, Xue HL, Corrales MP, Chang HM, Wong MC, Chen CP, Tan EK. A randomized controlled trial of rivastigmine in patients with cognitive impairment no dementia because of cerebrovascular disease. Acta Neurol Scand. 2010;121:217–24.

    Article  CAS  PubMed  Google Scholar 

  65. Moretti R, Torre P, Antonello RM, Cazzato G, Bava A. Rivastigmine in subcortical vascular dementia: an open 22-month study. J Neurol Sci. 2002;203–204:141–6.

    Article  PubMed  Google Scholar 

  66. Parsons CG, Danysz W, Quack G. Memantine is a clinically well tolerated N-methyl-d-aspartate (NMDA) receptor antagonist—a review of preclinical data. Neuropharmacology. 1999;38:735–67.

    Article  CAS  PubMed  Google Scholar 

  67. Frankiewicz T, Pilc A, Parsons CG. Differential effects of NMDA-receptor antagonists on long-term potentiation and hypoxic/hypoglycaemic excitotoxicity in hippocampal slices. Neuropharmacology. 2000;39:631–42.

    Article  CAS  PubMed  Google Scholar 

  68. McShane R, Areosa Sastre A, Minakaran N. Memantine for dementia. Cochrane Database Syst Rev. 2006;2:CD003154.

    Google Scholar 

  69. Orgogozo JM, Rigaud AS, Stöffler A, Möbius HJ, Forette F. Efficacy and safety of memantine in patients with mild to moderate vascular dementia: a randomized, placebo-controlled trial (MMM 300). Stroke. 2002;33:1834–9.

    Article  CAS  PubMed  Google Scholar 

  70. Wilcock G, Möbius HJ, Stöffler A, MMM 500 Group. A double-blind, placebo-controlled multicentre study of memantine in mild to moderate vascular dementia (MMM500). Int Clin Psychopharmacol. 2002;17:297–305.

    Article  CAS  PubMed  Google Scholar 

  71. Fioravanti M, Buckley AE. Citicoline (Cognizin) in the treatment of cognitive impairment. Clin Interv Aging. 2006;1(3):247–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  72. Fioravanti M, Yanagi M. Cytidinediphosphocholine (CDP-choline) for cognitive and behavioural disturbances associated with chronic cerebral disorders in the elderly. Cochrane Database Syst Rev. 2005;2:000269.

    Google Scholar 

  73. Cohen RA, Browndyke JN, Moser DJ, Paul RH, Gordon N, Sweet L. Long-term citicoline (cytidine diphosphate choline) use in patients with vascular dementia: neuroimaging and neuropsychological outcomes. Cerebrovasc Dis. 2003;16:199–204.

    Article  CAS  PubMed  Google Scholar 

  74. Alvarez-Sabín J, Ortega G, Jacas C, Santamarina E, Maisterra O, Ribo M, Molina C, Quintana M, Román GC. Long-term treatment with citicoline may improve poststroke vascular cognitive impairment. Cerebrovasc Dis. 2013;35:146–54.

    Article  PubMed  Google Scholar 

  75. Alvarez-Sabín J, Santamarina E, Maisterra O, Jacas C, Molina C, Quintana M. Long-term treatment with citicoline prevents cognitive decline and predicts a better quality of life after a first ischemic stroke. Prokai-Tatrai K (ed.) Int J Mol Sci. 2016;17:390.

  76. Guekht A, Skoog I, Edmundson S, Zakharov V, Korczyn AD. ARTEMIDA trial (a randomized trial of efficacy, 12 months international double-blind actovegin): a randomized controlled trial to assess the efficacy of actovegin in poststroke cognitive impairment. Stroke. 2017;48:1262–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  77. Nimmrich V, Eckert A. Calcium channel blockers and dementia. Br J Pharmacol. 2013;169:1203–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  78. Pantoni L, Rossi R, Inzitari D, Bianchi C, Beneke M, Erkinjuntti T, Wallin A. Efficacy and safety of nimodipine in subcortical vascular dementia: a subgroup analysis of the Scandinavian Multi-Infarct Dementia Trial. J Neurol Sci. 2000;175:124–34.

    Article  CAS  PubMed  Google Scholar 

  79. Hanyu H, Hirao K, Shimizu S, Sato T, Kiuchi A, Iwamoto T. Nilvadipine prevents cognitive decline of patients with mild cognitive impairment. Int J Geriatr Psychiatry. 2007;22:1264–6.

    Article  PubMed  Google Scholar 

  80. Hase Y, Okamoto Y, Fujita Y, Kitamura A, Nakabayashi H, Ito H, Maki T, Washida K, et al. Cilostazol, a phosphodiesterase inhibitor, prevents no-reflow and hemorrhage in mice with focal cerebral ischemia. Exp Neurol. 2012;233:523–33.

    Article  CAS  PubMed  Google Scholar 

  81. Sakurai H, Hanyu H, Sato T, Kume K, Hirao K, Kanetaka H, Iwamoto T. Effects of cilostazol on cognition and regional cerebral blood flow in patients with Alzheimer’s disease and cerebrovascular disease: a pilot study. Geriatr Gerontol Int. 2013;13:90–7.

    Article  PubMed  Google Scholar 

  82. Toda Y, K-i K, Saito M, Inaba T, Sakurazawa M, Katayama Y. The effect of cilostazol and aspirin pre-treatment against subsequent transient focal cerebral ischemia in rat. Neurol Res. 2014;36:1011–9.

    Article  CAS  PubMed  Google Scholar 

  83. Arai H, Takahashi T. A combination therapy of donepezil and cilostazol for patients with moderate Alzheimer’s disease: pilot follow up study. Am J Geriatr Psychiatry. 2009;17(4):353–4.

    Article  PubMed  Google Scholar 

  84. Watanabe T, Zhang N, Liu M, Tanaka R, Mizuno Y, Urabe T. Cilostazol protects against brain white matter damage and cognitive impairment in a rat model of chronic cerebral hypoperfusion. Stroke. 2006;37:1539–45.

    Article  CAS  PubMed  Google Scholar 

  85. El-Dessouki AM, Galal MA, Awad AS, Zaki HF. Neuroprotective effects of Simvastatin and Cilostazol in l-methionine-induced vascular dementia in rats. Mol Neurobiol. 2016. doi:10.1007/s12035-016-0051-8.

  86. Mielke R, Kittner B, Ghaemi M, Kessler J, Szelies B, Herholz K, Heiss WD. Propentofylline improves regional cerebral glucose metabolism and neuropsychologic performance in vascular dementia. J Neurol Sci. 1996;141:59–64.

    Article  CAS  PubMed  Google Scholar 

  87. Kittner B, Rössner M, Rother M. Clinical trials in dementia with propentofylline. Ann N Y Acad Sci. 1997;26(826):307–16.

    Article  Google Scholar 

  88. Möller HJ, Hartmann A, Kessler C, Rainer M, Brown T, Gamand S, Lehert P. Naftidrofuryl in the treatment of vascular dementia. Eur Arch Psychiatry Clin Neurosci. 2001;251:247–54.

    Article  PubMed  Google Scholar 

  89. Grossman WM, Standl A, May U, Laak VH, Hirche H. Naftidrofuryl in the treatment of mild senile dementia. Pharm Psychiatry. 1990;23:265–73.

    Google Scholar 

  90. Emeriau JP, Lehert P, Mosnier M. Efficacy of naftidrofuryl in patients with vascular or mixed dementia: results of a multicenter, double-blind trial. Clin Ther. 2000;22:834–44.

    Article  CAS  PubMed  Google Scholar 

  91. Möller HJ, Hartmann A, Kessler C, Rainer M, Brown T, Gamand S, Lehert P. Naftidrofuryl in the treatment of vascular dementia. Eur Arch Psychiatry Clin Neurosci. 2001;25:247–54.

    Article  Google Scholar 

  92. Hao Z, Liu M, Liu Z, Lv D. Huperzine A for vascular dementia. Cochrane Database Syst Rev. 2009;2:CD007365.

    Google Scholar 

  93. Szatmari SZ, Whitehouse PJ. Vinpocetine for cognitive impairment and dementia. Cochrane Database Syst Rev. 2003;1:003119.

    Google Scholar 

  94. Flicker L, Grimley Evans G. Piracetam for dementia or cognitive impairment. Cochrane Database Syst Rev. 2001;2:CD001011.

    Google Scholar 

  95. Hurd MD, Martorell P, Delavande D, Mullen KJ, Langa KM. Monetary costs of dementia in the United States. N Engl J Med. 2013;368:1326–34.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  96. Kling MA, Trojanowski JO, Wolk DA, Lee VM, Arnold SE. Vascular disease and dementias: paradigm shiftrs to drive research in new directions. Alzheimers Dement. 2013;9(1):76–92.

    Article  PubMed  Google Scholar 

  97. Snyder HM, Corriveau RA, Craft S, Faber JE, Greenberg SM, Knopman D, et al. Vascular contributions to cognitive impairment and dementia including Alzheimer’s disease. Alzheimers Dement. 2015;11(6):710–7. doi:10.1016/j.jalz.2014.10.008.

    Article  PubMed  Google Scholar 

  98. Hainsworth AH, Allan SM, Boltze J, Cunningham C, Farris C, et al. Translational models for vascular cognitive impairment: a review including larger species. BMC Med. 2017;25(15):16.

    Article  Google Scholar 

  99. Barone FC, Gustafson D, Crystal HA, Moreno H, Adamski MG, Arai K, et al. First translational ‘think tank’ of cerebrovascular disease, cognitive impairment and dementia. J Trans Med. 2016;14:50. doi:10.1186/s12967-016-0806-z.

    Article  Google Scholar 

  100. O’Brien JT, Thomas A. Non-Alzheimer’s dementia 3. Vascular dementia. Lancet. 2015;386:1698–706.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Stroke and Vascular Neurology, Mercy Health Hauenstein Neurosciences, 200 Jefferson Street SE, Grand Rapids, MI, 49503, USA

    Muhammad U. Farooq, Jiangyong Min, Christopher Goshgarian & Philip B. Gorelick

  2. Department Translational Science and Molecular Medicine, Michigan State University College of Human Medicine, 220 Cherry Street SE Room H 3037, Grand Rapids, MI, 49503, USA

    Philip B. Gorelick

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  1. Muhammad U. Farooq
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MUF, JM, and CG have no conflicts of interest in relation to this manuscript. PBG served as a member on the data safety and monitoring board for a Novartis study of LCZ 696 in cognitive vitality in heart failure.

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Farooq, M.U., Min, J., Goshgarian, C. et al. Pharmacotherapy for Vascular Cognitive Impairment. CNS Drugs 31, 759–776 (2017). https://doi.org/10.1007/s40263-017-0459-3

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