elderly (Zhang-Nunes et al., 2006), this necessitates the use of anti-platelet drugs with little risk of hemorrhage (Charidimou et al., 2012). The second Cilostazol Stroke Prevention Study (CSPS2) for patients with cerebral infarction showed that the hemorrhagic stroke was significantly less frequent in cilostazol treatment than with aspirin (Shinohara et al., 2010; Uchiyama et al., 2014). The prevention of cerebral hemorrhage may be explained by reproducible experimental evidence showing that cilostazol inhibits expression of matrix metalloproteinase-9 and protects vascular endothelial cells (Ishiguro et al., 2010; Hase et al., 2012; Kasahara et al., 2012). Endothelial protection with cilostazol mediates increase in nitric oxide, which dilates blood vessels (Oyama et al., 2011), leading to increased cerebral blood flow (Mochizuki et al., 2001; Matsumoto et al., 2011; Sakurai et al., 2013). These results suggest that cilostazol could be suitable for patients with both AD and CVD, the most common type of dementia in the elderly.
