ما هو علاج الخرف الناجم عن مرض الأوعية الدموية الدماغية؟

References

• Non-pharmacological and pharmacological approaches to management of VCI and cognitive rehabilitation should be used.
• Individuals with VCI should be assessed for medical (e.g., hypertension, diabetes, lipids, atrial fibrillation, sleep disorders) and lifestyle vascular risk factors (e.g., diet, sodium intake, cholesterol, exercise, weight, alcohol intake, smoking).
• Medical and lifestyle vascular risk factors should be managed to achieve maximum risk reduction for first-ever or recurrent stroke, as these are associated with cognitive impairment.
• For individuals with cognitive disorders in which a vascular contribution is known or suspected, antihypertensive therapy should be strongly considered for individuals with an average diastolic blood pressure consistently ≥90 mmHg, or for individuals with an average systolic blood pressure consistently ≥140 mmHg.
• Antiplatelet or antithrombotic use should be guided by existing primary and secondary stroke or vascular prevention indications.
• The effects of low dose acetylsalicylic acid (ASA) in individuals with VCI or vascular dementia who have covert brain infarcts detected on neuroimaging without history of stroke have not been defined. The use of ASA in this setting could be considered, but the benefit is unclear.
• Cholinesterase inhibitors (donepezil, rivastigmine and galantamine) and the N-methyl-D-aspartate (NMDA) receptor antagonist memantine may be considered in individual persons with vascular or mixed dementia, based on randomized trials showing small magnitude benefits in cognitive outcomes.