Pharmacological Treatment: Current Evidence for Clinical Uses of Alzheimer’s Disease Drugs

Alzheimer’s disease (AD) and vascular dementia (VaD) are the two most common forms of dementia. Cholinesterase inhibitors and N-methyl-d-aspartate receptor antagonists are approved and widely used in AD treatment. The role of these AD drugs for VaD is controversial. This chapter reviews the current evidence for the use of AD drugs in the treatment of VaD. To date, there have been eight published randomized controlled trials (three donepezil, two galantamine, one rivastigmine, and two memantine trials) evaluating the efficacy and safety of AD drugs in VaD. These clinical trials have demonstrated small benefits in cognitive function but without consistent corresponding effects on global function. Currently, there is not enough evidence to recommend widespread use of AD drugs in VaD.