Vascular Dementia Beyond Conventional Treatment: The Role of Neuroprotective Agents and Personalized Antiplatelet Therapy

Year 2025, Volume: 11 Issue: 2, 128 - 135, 31.05.2025

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https://doi.org/10.19127/mbsjohs.1655774

Abstract

Vascular dementia is a neurocognitive disorder caused by impaired cerebral blood flow due to vascular pathologies. Conventional pharmacological treatments often yield limited efficacy, necessitating adjunctive therapeutic strategies.
We report the case of a 75-year-old male patient with a history of hypertension and hyperlipidemia, presenting with progressive cognitive decline and psychiatric symptoms over four years. Initially misdiagnosed with a primary psychiatric disorder, the patient underwent various psychiatric treatments without significant improvement. Neurological evaluation revealed ischemic gliotic changes on magnetic resonance imaging (MRI), leading to a diagnosis of early-stage vascular dementia. Standard dementia treatment with donepezil and memantine was supplemented with citicoline, omega-3-6-9 fatty acids, and magnesium L-threonate. Furthermore, aspirin resistance testing revealed total resistance, prompting a switch to clopidogrel therapy. After four months, the patient showed cognitive improvement, with his Mini-Mental State Examination (MMSE) score increasing from 24 to 26.
This case highlights the importance of a comprehensive neurological and psychiatric evaluation in patients with cognitive decline. The integration of neuroprotective agents such as citicoline, omega fatty acids, and magnesium L-threonate may offer additional cognitive benefits in vascular dementia. Moreover, aspirin resistance should be considered in patients receiving antiplatelet therapy to optimize cerebrovascular protection.
Vascular dementia requires a multidisciplinary approach, including cognitive, psychiatric, and vascular risk management. Adjunctive neuroprotective therapies and personalized antiplatelet strategies may improve patient outcomes. Further research is needed to establish standardized protocols for managing vascular dementia with emerging therapeutic agents

Keywords

Vascular dementia , Mini-Mental State Examination (MMSE) , citicoline , magnesium L-threonate , aspirin resistance

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