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. 2000;2000(4):CD001296.
doi: 10.1002/14651858.CD001296.

Aspirin for vascular dementia

P S Williams  1 , G Rands, M Orrel, A Spector
Affiliations

Aspirin for vascular dementia

P S Williams et al. Cochrane Database Syst Rev. 2000.

Abstract

Background: For patients with a diagnosis of vascular dementia there is evidence that aspirin is widely prescribed - in one study, completed by geriatricians and psychiatrists in the UK, 80% of patients with cognitive impairment (with vascular risk factors) were prescribed aspirin. However, a number of queries remain unanswered: Is there convincing evidence that aspirin benefits patients with vascular dementia? Does aspirin affect cognition or improve prognosis? In addition, does the risk of cerebral or gastric haemorrhage outweigh any benefit?

Objectives: To assess the evidence of effectiveness of the use of aspirin for vascular dementia.

Search strategy: Computerized databases were searched independently by two reviewers. In addition, relevant websites were searched and some journals were handsearched. Specialists in the field were approached for unpublished material and any publications found were searched for additional references. The most recent search for trials was carried out in February 2000.

Selection criteria: All randomized controlled trials investigating the effect of aspirin for vascular dementia are included. Inclusion/exclusion of studies comprised systematic assessment of the quality of study design and the risk of bias.

Data collection and analysis: Data were extracted independently by both reviewers, using a previously tested data extraction form and, where required, authors were contacted for data not provided in the papers. The aim is to evaluate data recorded via tools assessing cognitive and behavioural changes along with mortality, morbidity and institutionalization data.

Main results: No trials are eligible for inclusion in this review.

Reviewer's conclusions: There is no evidence that aspirin is effective in treating patients with a diagnosis of vascular dementia. Further research is needed to assess the effect of aspirin on cognition, and on other outcomes such as behaviour, and quality of life. At present there is no evidence relating to other queries about the use of aspirin for dementia (these are described in the Background section of this review). The most recent search for references to relevant research was carried out in February 2000, but no new evidence was found.

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Conflict of interest statement

None known.

Update of

References

References to studies excluded from this review

AD 2000 {published data only}
    1. AD2000 Collaborative Group, Bentham P, Gray R, Sellwood E, Hills R, Crome P, Raftery J. Aspirin in Alzheimer's disease (AD2000): a randomised open‐label trial. Lancet Neurology 2008;7(1):41‐9. - PubMed
ASPREE 2008 {published data only}
    1. Anon. Aspirin for the prevention of cognitive decline in the Elderly: a Neuro‐Vascular Imaging Study (ENVIS‐ion), a sub‐study of ASPirin in Reducing Events in the Elderly (ASPREE); [Official title] A multi‐centre, randomised, double‐blind, placebo controlled trial of the effects of 100mg enteric‐coated aspirin on rate of increase of magnetic resonance imaging (MRI)‐based white matter hyperintensity (WMH) and silent brain infarction (SBI), 2008. www.mrw.interscience.wiley.com/cochrane/clcentral/articles/617/CN‐007246.... (accessed 20 August 2012).
Broe 2000 {published data only}
    1. Broe GA, Grayson DA, Creasey HM, Waite LM, Casey BJ, Bennett HP, et al. Anti‐inflammatory drugs protect against Alzheimer's disease at low doses. Archives of Neurology 2000;57(11):1586‐91. - PubMed
Guekht 2011 {published data only}
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Henderson 1997 {published data only}
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Meyer 1989 {published data only}
    1. Meyer JS, Rogers RL, McClintic K, Mortel KF. Controlled clinical trial of daily aspirin therapy in multi‐infarct dementia. Stroke 1988;19(1):148. - PubMed
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Moretti 2004 {published data only}
    1. Moretti R, Torre P, Antonello RM, Cazzato G, Griggio S, Ukmar M, et al. Rivastigmine superior to aspirin plus nimodipine in subcortical vascular dementia: an open 16 month, comparative study. International Journal of Clinical Practice 2004;58(4):346‐53. - PubMed
Price 2008 {published data only}
    1. Price JF, Stewart MC, Deary IJ, Murray GD, Sandercock P, Butcher I, et al. Low dose aspirin and cognitive function in middle aged to elderly adults: randomised controlled trial. BMJ 2008;337:a1198. - PMC - PubMed
Richard 2010 {published data only}
    1. Richard E, Gouw AA, Scheltens P, Gool WA. Vascular care in patients with Alzheimer disease with cerebrovascular lesions slows progression of white matter lesions on MRI: the evaluation of vascular care in Alzheimer's disease (EVA) study. Stroke 2010;41(3):554‐6. - PubMed
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Szekely 2008 {published data only}
    1. Szekely CA, Breitner JC, Fitzpatrick AL, Rea TD, Psaty BM, Kuller LH, et al. NSAID use and dementia risk in the Cardiovascular Health Study: role of APOE and NSAID type. Neurology 2008;70(1):17‐24. - PMC - PubMed
Teramoto 2010 {published data only}
    1. Teramoto T, Shimada K, Uchiyama S, Sugawara M, Goto Y, Yamada N, et al. Rationale, design, and baseline data of the Japanese Primary Prevention Project (JPPP) ‐ a randomized, open‐label, controlled trial of aspirin versus no aspirin in patients with multiple risk factors for vascular events. American Heart Journal 2010;159(3):361‐9. - PubMed
Thoonsen 2010 {published data only}
    1. Thoonsen H, Richard E, Bentham P, Gray R, Haan RJ, Gool WA, et al. Aspirin in Alzheimer's disease: increased risk of intracerebral haemorrhage ‐ cause for concern? Cerebrovascular Diseases. Proceedings of the 19th European Stroke Conference; 201 May 25‐28; Barcelona. Basal: Karger, 2010. - PubMed
Yining 2011 {published data only}
    1. Yining H (principal investigator). Cilostazol versus aspirin for vascular dementia in poststroke patients with white matter lesions (CAVAD). clinicaltrials.gov/ct2/show/NCT00847860, 2011. (accessed 20 August 2012).
Zhai 2010 {published data only}
    1. Zhai Q‐J, Yue X‐Y, Hong Z, Xu G‐L, Liu X‐F. Efficacy observation of batroxobin for treatment of vascular cognitive impairment. Chinese Journal of Cerebrovascular Diseases 2010;7(2):73‐6.

Additional references

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References to other published versions of this review

Rands 2000
    1. Rands G, Orrell M, Spector A. Aspirin for vascular dementia. Cochrane Database of Systematic Reviews 2000, Issue 4. [DOI: 10.1002/14651858.CD001296] - DOI - PubMed

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