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Rivastigmine for vascular cognitive impairment

Birks J, McGuinness B, Craig D
Published Online: 
31 May 2013

Vascular dementia (i.e. dementia caused by disease of blood vessels affecting the supply of blood to the brain) is one of the most common types of dementia. It includes dementia caused by stroke. It may exist by itself or with other common dementias such as Alzheimer's disease. Sometimes vascular disease can present with cognitive problems which are less severe than dementia. Those with vascular dementia may have significant cognitive impairment without major memory loss. The term vascular cognitive impairment (VCI) is useful, because of the range of different ways in which people are affected. Rivastigmine is a drug widely used in Alzheimer's disease (AD). It works by preventing breakdown of acetylcholine, a neurotransmitter (signalling molecule). Levels of acetylcholine are reduced in VCI as well as in AD and so it may also help people with VCI. Researchers searched for all trials that compared rivastigmine with placebo in people with VCI, and identified three. Only one of these showed any significant results, and it did show some benefit for people with VCI who took rivastigmine. However, nausea and vomiting were a frequent side effect of taking the drug. Therefore it remains uncertain how useful rivastigmine is for people with VCI .

This record should be cited as: 
Birks J, McGuinness B, Craig D. Rivastigmine for vascular cognitive impairment. Cochrane Database of Systematic Reviews 2013, Issue 5. Art. No.: CD004744. DOI: 10.1002/14651858.CD004744.pub3
Assessed as up to date: 
12 February 2013