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Managing Vascular Dementia and Other Types

Treating Vascular Dementia

There is no standard drug treatment for vascular dementia (multi-infarct dementia is the most common form), although some of the symptoms, such as depression, can be treated. Other vascular dementia treatments aim to reduce the risk factors for further brain damage. However, some studies have found that cholinesterase inhibitors, such as galantamine, and other Alzheimer's disease drugs, can improve cognitive function and behavioral symptoms in people with early vascular dementia.
Treating the underlying risk factors for stroke and heart attack can help to slow down or halt the progression of vascular dementia. To prevent a stroke or transient ischemic attack (known as a TIA or mini-stroke), doctors may prescribe medicines to control high blood pressure (hypertension), high cholesterol, heart disease, atrial fibrillation, and diabetes.
(Click Stroke Prevention or Heart Disease Prevention for more information.)
Doctors also sometimes prescribe aspirin, warfarin, or other drugs to prevent clots from forming in small blood vessels. When people with dementia have blockages in blood vessels, doctors may recommend surgical procedures, such as carotid endarterectomy, stenting, or angioplasty, to restore the normal blood supply. Healthcare providers may also prescribe medications to relieve restlessness or depression, or to help people with vascular dementia sleep better.

Other Dementia Treatment Options

Some studies have suggested that cholinesterase inhibitors such as donepezil (Aricept) can reduce behavioral symptoms in some people with dementia associated with Parkinson's disease.
At present, no medications are approved specifically for frontotemporal dementia treatment or most other types of progressive dementia. However, sedatives, antidepressants, and other medications may be useful in treating specific symptoms and behavioral problems associated with these forms of dementia.
Scientists continue to search for specific treatments to help people with Lewy body dementia. Current options are symptomatic, often involving the use of medication to control the parkinsonian and psychiatric symptoms. Although antiparkinsonian medication may help reduce tremor and loss of muscle movement, it may worsen symptoms such as hallucinations and delusions. Also, drugs prescribed for psychiatric symptoms may make movement problems worse. Several studies have suggested that cholinesterase inhibitors may be able to improve cognitive function and behavioral symptoms in people with Lewy body disease.
There is no known dementia treatment that can cure or control Creutzfeldt-Jakob disease. Current options are aimed at alleviating symptoms and making the person as comfortable as possible. Opiate drugs can help relieve pain, and the drugs clonazepam and sodium valproate may help relieve myoclonus. During later stages of the disease, treatment for Creutzfeldt-Jakob focuses on supportive care, such as administering intravenous fluids and changing the person's position frequently to prevent bedsores.
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