J Korean Neurol Assoc.  2008 Aug;26(3):209-215.

Clinical Course of Small Vessel Dementia Patients According to Cholinesterase Inhibitor Treatment

Affiliations
  • 1Department of Neurology, Hyoja Geriatric Hospital, Yongin, Korea. ytkwak@drkwak.com
  • 2Department of Neurology, Sanbon Hospital, Wonkwang University College of Medicine, Sanbon, Korea.
  • 3Department of Neurology, Yonsei University College of Medicine, Brain Research Institute, Seoul, Korea.

Abstract

BACKGROUND
Small vessel dementia (SVD) is the most frequent cause of vascular dementia and is regarded a distinct clinical entity. However, the data on the natural course of SVD and drug trials specifically aiming SVD have been sparse. The aim of this study was to answer the following three questions: 1) How does SVD progress? 2) Does cholinesterase inhibitor therapy improves cognitive symptoms and daily activity of life (ADL) in SVD? 3) Is there any clinical difference among the subtypes of SVD?
METHODS
According to cholinesterase inhibitor medications, patients with SVD were retrospectively analyzed using Hyoja Dementia registry. In this study, effects of treatment were assessed by comparing the scores of Korea version Mini-Mental State Examination (MMSE), Clinical Dementia Rating scale (CDR), Functional Independence Measure (FIM) at the base line with those at endpoints.
RESULTS
After 12 months, the mean MMSE, CDR, FIM scores improved significantly in the cholinesterase inhibitor treatment group, compared with that in no-treatment group. In no-treatment group, annual decline of MMSE was 2.7, compared with 0.3 increment in the treatment group. White matter type of SVD showed worst prognosis compared with other types.
CONCLUSIONS
This study suggests that SVD has more benign clinical course than previously reported, and cholinesterase inhibitor improves cognitive and ADL functions in SVD. Among the subtypes of SVD, the white matter type may have poor prognosis.

Keyword

Small vessel dementia, Cholinesterase inhibitor, White matter

MeSH Terms

Activities of Daily Living
Cholinesterases
Dementia
Dementia, Vascular
Deoxycytidine
Glycosaminoglycans
Humans
Korea
Neurobehavioral Manifestations
Prognosis
Retrospective Studies
Cholinesterases
Deoxycytidine
Glycosaminoglycans
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