International Psychogeriatrics
Volume 15, Supplement 1 - 2003
Rivastigmine in Vascular Dementia SHOONA VINCENT AND ROGER LANE
ABSTRACT. Vascular dementia (VaD), like Alzheimer’s disease (AD), is associated with cholinergic
deficits. Rivastigmine provides sustained, brain-selective inhibition of acetylcholinesterase
and butyrylcholinesterase. Preliminary data suggest that rivastigmine may provide significant
benefits in patients with AD and cerebrovascular disease (mixed dementia), and in patients with
VaD. Open-label rivastigmine treatment has been associated with improved cognitive and
functional abilities, behavioral symptoms, and reduced caregiver stress in a small pilot study
in these patients. Larger, prospective, double-blind studies of rivastigmine in patients with
VaD are under way. These studies will confirm whether rivastigmine is an efficacious treatment
option for a range of patients for whom, until now, there have been few symptomatic therapies.
