salicylates and Dementia--Vascular

Vascular dementia is the second commonest cause of dementia after Alzheimer's disease. The most important risk factor for this is previous cerebral vascular accident.. To eliminate the risk factors and/or progression of this illness would be of considerable benefit to these patients. Triflusal, a platelet anti-aggregant chemically related to the salicylates, whose clinical efficacy has been shown in cardiac and cerebrovascular pathology, has been used in the treatment of patients with vascular dementia.. An open study was done a sample of 73 patients with vascular dementia randomly distributed into two groups (control and undergoing treatment with triflusal).. To check the efficacy of treatment with triflusal, the percentage of variation in the scoring of the Cognitive Mini Examination was used after a clinical course of 12 months (IVP 12), considering the critical point of no efficacy to be a loss equal or greater than 10%. In the control group, 33% (8/24) and in the group treated with triflusal 8% (3/35) had a negative course which was greater than this critical point.. The difference in the IVP 12 between the two groups was statistically significant (p = 0.0375), with a statistical power of 87% (beta = 0.13). This gives triflusal a therapeutic activity which is sufficient to limit cognitive deterioration of patient with vascular dementia.

Topics: Aged; Cerebrovascular Disorders; Dementia, Vascular; Female; Humans; Male; Platelet Aggregation Inhibitors; Retrospective Studies; Risk Factors; Salicylates

Previous studies have suggested that the use of nonsteroidal antiinflammatory drugs (NSAIDs) may help to prevent Alzheimer's disease. The results, however, are inconsistent.. We studied the association between the use of NSAIDs and Alzheimer's disease and vascular dementia in a prospective, population-based cohort study of 6989 subjects 55 years of age or older who were free of dementia at base line, in 1991. To detect new cases of dementia, follow-up screening was performed in 1993 and 1994 and again in 1997 through 1999. The risk of Alzheimer's disease was estimated in relation to the use of NSAIDs as documented in pharmacy records. We defined four mutually exclusive categories of use: nonuse, short-term use (1 month or less of cumulative use), intermediate-term use (more than 1 but less than 24 months of cumulative use), and long-term use (24 months or more of cumulative use). Adjustments were made by Cox regression analysis for age, sex, education, smoking status, and the use or nonuse of salicylates, histamine Hz-receptor antagonists, antihypertensive agents, and hypoglycemic agents.. During an average follow-up period of 6.8 years, dementia developed in 394 subjects, of whom 293 had Alzheimer's disease, 56 vascular dementia, and 45 other types of dementia. The relative risk of Alzheimer's disease was 0.95 (95 percent confidence interval, 0.70 to 1.29) in subjects with short-term use of NSAIDs, 0.83 (95 percent confidence interval, 0.62 to 1.11) in those with intermediate-term use, and 0.20 (95 percent confidence interval, 0.05 to 0.83) in those with long-term use. The risk did not vary according to age. The use of NSAIDs was not associated with a reduction in the risk of vascular dementia.. The long-term use of NSAIDs may protect against Alzheimer's disease but not against vascular dementia.

Topics: Aged; Alzheimer Disease; Anti-Inflammatory Agents, Non-Steroidal; Cohort Studies; Dementia, Vascular; Drug Administration Schedule; Female; Humans; Male; Middle Aged; Proportional Hazards Models; Prospective Studies; Risk; Salicylates