Aricept to Improve Functional Tasks in Vascular Dementia

All participants will receive a behavioral intervention as part of the testing protocol: they
will be asked to generate words to complete a phrase as they read written steps to perform
functional tasks. Mood will be assessed using the Geriatric Depression Scale.(see page 8)
Participants will be asked to estimate their memory, immediate attention mood, functional
tasks (performing cooking and financial task) and "ability to take medications correctly"
(pre-test or "offline" ratings, abstract judgments of their own ability not based directly on
performance). They will perform self-assessments of their cognitive, functional abilities and
mood using Likert scales. They will mark each of 5 vertical (23.5 cm) lines centered on white
paper to indicate their ability. Each line will be labeled for each domain.

To estimate of naming ability, show the subject the Likert Scale (attached) for the naming
domain. Then explain: "This scale is to measure how well you think your ability to name. Here
is the top where you will mark if you think your performance is perfect, here is the bottom
if you think you are terrible. You may be somewhere in between. (broadly indicated the whole
middle area) mark where you think your performance would belong on this scale".

This standard protocol will be used by the examiner in this study to explain each domain with
specific types of tasks, and give subjects practical hypothetical examples of good and poor
performance.

Ability to take medication: Functional memory as applied to medication compliance will be
assessed with the Hopkins Medication Schedule (HMS). This test has two part, HMS and pill
box. The test will serve as a good evaluation of subject's functional memory, which we
suspect it will be most strongly affected by Anosognosia.

The HMS: the participant was read (and read along with) a hypothetical scenario in which her
physician gave her 1 prescription for an antibiotic and for aspirin to treat an infection
along with directions for taking each. The participant was then asked to plan a schedule for
taking these medications and water during the course of a day, following the instructions
provided.

Inclusion Criteria:

1. I am 18 to100 yrs old.

2. I had one stroke 4 months to 5 yrs ago

3. I am not taking Aricept or other cholinesterase inhibitors (e.g. Exelon, Razadyne) or
memantine (Namenda).

Exclusion Criteria:

1. I have history of dementia and or have been diagnosed with a memory disorder prior to
my stroke.

2. I have been on anti-depressants or other cognitive enhancing drugs for less than 3
months and the dose is not stabilized yet.

3. I consume alcohol more than or equivalent of 4 ounces hard liquor weekly.

4. I am taking oral anticholinergic medications like Bethanechol, Bentyl or Detrol.

5. I am a woman of childbearing potential or I am pregnant or a nursing mother.

6. I have a history of chronic vomiting or diarrhea.

7. I am allergic to Aricept.