Vascular Dementia: From Pathophysiology to Therapeutic Frontiers.
Level 5 - mechanism / opinion, no new human data
Narrative review of mechanisms and investigational therapies without systematic review methodology or new human data.
PubMed 41010812 · doi:10.3390/jcm14186611
What was done
This narrative review summarizes the pathophysiological mechanisms, genetic susceptibility factors (such as NOTCH3 mutations), diagnostic tools (fluid biomarkers and neuroimaging), and emerging therapeutic strategies for vascular dementia (VaD).
What was found
The abstract reports no quantitative data or numerical findings. It identifies core pathological drivers of VaD—including cerebral hypoperfusion, blood-brain barrier disruption, glymphatic impairment, neuroinflammation, demyelination, and synaptic loss—and highlights emerging pharmacological candidates such as phosphodiesterase inhibitors, NLRP3 inflammasome inhibitors, senolytics, and remyelination agents, noting that most remain investigational with limited Phase III evidence.
Why it matters
Vascular dementia is the second most common form of dementia, and this review outlines the shift from standard vascular risk management toward multi-target, mechanism-based therapeutic strategies.
Limits
As a narrative review, it presents no original empirical data, quantitative synthesis, or systematic search methodology. Most discussed therapeutic strategies remain experimental and lack confirmatory Phase III clinical trial data.
Cited by
- supports Cerebral small vessel disease is the second most common form of dementia behind Alzheimer's disease.