How good are cognitive enhancers in treating vascular cognitive impairment?

David A. Merrill, MD
If significant vascular cognitive impairment symptoms have already developed and you're wondering if it would be helpful to take cognitive enhancers, the answer is maybe or maybe not.

Both cholinesterase inhibitors and memantine were developed relating to the research of the degenerative Alzheimer's disease process, and in vascular dementia where there's no degenerative Alzheimer's process the evidence is mixed. But somebody who is experiencing the very beginnings of Alzheimer's disease might have two things going on at once, a so-called mixed dementia of both Alzheimer's and vascular disease, in which case cognitive enhancers would be helpful.

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