neurologic disorders
Vascular Cognitive Impairment and Dementia
Treatment of Vascular Cognitive Impairment and Dementia
Safety and supportive measures Management of vascular risk factors, including smoking cessation Treatment for vascular cognitive impairment and dementia are similar to those of other dementias. For example, the environment should be bright, cheerful, and familiar, and it should be designed to reinforce orientation (eg, placement of large clocks and calendars in the room). Measures to ensure patient safety (eg, signal monitoring systems for patients who wander) should be implemented. Troublesome symptoms can be treated. Managing vascular risk factors (eg, hypertension, diabetes, hyperlipidemia) may slow the progression of vascular cognitive impairment and dementia and help prevent future strokes, which could cause more cognitive impairment. Management includes the following: Blood pressure control Cholesterol-lowering therapy Regulation of plasma glucose (90 to 150 mg/dL) Smoking cessation Medications, such as Medications to treat Alzheimer disease and However, efficacy of cholinesterase inhibitors andmemantineis uncertain in vascular cognitive impairment and dementia. Nonetheless, a trial of these medications is reasonable because older patients with vascular cognitive impairment and dementia may also have Alzheimer disease. 