There are multiple studies addressing pharmacological interventions for delaying the progression of CD, such as monoclonal antibodies, cholinesterase inhibitors and neurohormonal modulators. Monoclonal antibodies like adacanumab have been reserved mainly for mild cognitive impairment, whereas cholinesterase inhibitors (rivastigmine, donepezil) and neurohormonal modulators (memantine) are known to improve cognitive function in Alzheimer’s disease with limited evidence on their effect in vascular dementia. Here, BCHE is linked to Cowden disease.