Clinical Improvement in a Patient with Parkinsonism and Vascular Dementia Receiving PCSK9 Inhibitor for Ischemic Heart Disease: A Case Report

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Dementia is a disorder that is characterized by a decline in one or more of the cognitive functions learning and memory language executive functions attention motor and social abilities.[5]The dysfunctions are usually severe enough to interfere with the patient’s daily activities and independence. The main underlying cause of vascular dementia is cerebrovascular disease or insufficient cerebral microvascular circulation.[7] The vascular dementia should be treated for vascular risk factors especially hypertension diabetes hypercholesterolemia smoking and inactivity.[8][9].The standard pharmacological interventions are Acetylcholinesterase inhibitors donepezil galantamine and N-Methyl-D-aspartate receptor antagonists Memantine. However recovery of lost cognitive function beyond the initial recovery from vascular dementia is not likely. Moreover Parkinson disease is another common neurological disease caused by loss of dopaminergic neurons of substantia nigra pars compacta. The primary treatments are anticholinergics benztropine trihexyphenidyl dopamine precursors levodopa carvidopa COMT inhibitors Entacapone MAO B inhibitor Selegilineand Amantadine. Above treatments can slow down the disease progression but they cannot reverse the disease course. Here we are reporting a patient with dementia and parkinson’s disease who was significantly improved by  ministration of PCSK9 inhibitor.