ESOC 2025 | Combining pharmacological and non-pharmacological treatments in vascular cognitive impairment

Whenever I think about treatments, I always think about both drug and non-drug treatments, and we shouldn’t think of them in isolation. What we’ve learned from the Alzheimer’s field is that multi-component interventions have the greatest efficacy. So I think we’re going to move to a similar lens of looking at treatment in vascular cognitive impairment. We’re going to start to compare evidence-based drug treatments, both prevention and treatments if they come along, with non-pharmacological treatments as well. Again, if we go back to all-cause dementia or Alzheimer’s dementia, we know from the Lancet Commission that there are lots of modifiable risk factors. And in middle age, many of those are lifestyle vascular risk factors. They’re things like smoking cessation, improving sedentary behaviour. So again, many people may think that this isn’t the realm of a cognitive neurologist, but I think what we need to be doing is public health messaging and getting people to attend to those modifiable risk factors.

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