The purpose of this study is to examine the effects of cilostazol augmentation in mild to
moderate Alzheimer disease patients with subcortical white matter hyperintensities (WMHI)
treated by donepezil.
Dementia is the most disabling disease in the old age. The prevalence of dementia is 5-10% of
the elders. AchEIs (donepezil, galantamine, rivastigmine) are used to treat mild to moderate
dementia, but these drugs only relate to symptomatic improvement and the response rates are
less than 30%.
Cilostazol is a cyclic adenosine monophosphate phosphodiesterase 3 inhibitor (PDE3I) and used
as antiplatelet agent in subcortical vascular disease (WMHI). And it upregulates
phosphorylation of cyclic adenosine monophosphate-pathway response element binding protein
(CREB) which plays a crucial role in memory enhancement and synaptic plasticity related to
neurodegeneration prevention.
The investigators will try cilostazol augmentation in dementia patients with WMHI receiving
donepezil to see the addictive effects of cilostazol using cognitive tasks and PET imaging.