Related Experiment Video
Updated: May 2, 2026
10:36
In Vitro Assays to Assess Blood-brain Barrier Mesh-like Vessel Formation and Disruption
Published on: June 20, 2017
7.7K
Vascular basis of Alzheimer's pathogenesis
1Division of Neuropathology, University of California-San Diego, 1363 Shinly, Suite 100, Escondido, CA 92026, USA. jdelator@nctimes.net
Annals of the New York Academy of Sciences
|December 14, 2002
Summary
Alzheimer's disease (AD) is increasingly viewed as a vascular disorder, not purely neurodegenerative. Evidence links vascular factors to AD pathology, suggesting a reclassification for better treatment and prevention strategies.
Area of Science:
- Neurology
- Vascular Biology
- Gerontology
Background:
- Alzheimer's disease (AD) is traditionally considered a neurodegenerative disorder.
- Emerging evidence suggests a significant vascular component in AD pathogenesis.
- Vascular dementia (VaD) shares risk factors and pathologies with AD.
Purpose of the Study:
- To review evidence supporting AD as a primary vascular disorder.
- To propose a reclassification of AD based on its vascular etiology.
- To explore the mechanisms linking cerebral hypoperfusion to AD pathology.
Main Methods:
- Review of epidemiological studies linking vascular risk factors to AD.
- Analysis of shared risk factors and clinical symptoms between AD and VaD.
- Examination of evidence for therapeutic benefits of cerebrovascular interventions in AD.
- Evaluation of cerebral perfusion measurements for preclinical AD detection.
Main Results:
- Epidemiologic studies link vascular risk factors to AD-related cerebrovascular pathology.
- Pharmacotherapy improving cerebrovascular insufficiency shows benefits for AD symptoms.
- Cerebral hypoperfusion is implicated in triggering hypometabolic and degenerative changes.
- Overlapping pathologies and clinical symptoms exist between AD and VaD.
Conclusions:
- AD should be reclassified as a vascular disorder based on extensive evidence.
- Reclassification will improve treatment targets, diagnosis, and prevention strategies for AD.
- Chronic cerebral hypoperfusion, CATCH, and endothelial nitric oxide synthase play roles in AD pathogenesis.
Related Concept Videos
01:26Alzheimer's Disease: Overview
1.7K
Alzheimer's Disease (AD) is a continually advancing neurodegenerative disorder, distinguished by escalating memory loss, cognitive dysfunction, and dementia. The disease unfolds in three stages: preclinical, mild cognitive impairment (MCI), and dementia. Its onset is insidious, and the progression gradual, with the cause not well explained by other disorders.
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
The clinical diagnosis of AD hinges on the presence of memory and other cognitive impairments. Biomarkers, such as changes in Aβ...
1.7K
01:29Hemorrhagic Stroke ll: Pathophysiology
30
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
30
01:22Cerebral Edema ll: Pathophysiology
19
Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this...
19
01:29Alzheimer Disease l: Introduction
21
Alzheimer disease is a chronic, progressive, and irreversible neurodegenerative disorder and the most common cause of dementia in older adults. It leads to gradual neuronal loss, causing cognitive decline, behavioral changes, and loss of functional independence.Risk Factors and EtiologyThe disease is multifactorial. Age is the strongest risk factor, with prevalence doubling every 5 years after age 65. Genetic factors include mutations in genes such as APP, PSEN1, and PSEN2, which are associated...
21
01:23Alzheimer Disease ll: Pathophysiology
35
Alzheimer disease involves structural changes in the brain that begin long before symptoms appear. The most distinctive features are extracellular neuritic plaques and intracellular neurofibrillary tangles.Neuritic plaques form in the cerebral cortex and around blood vessels. These plaques contain a dense core of beta-amyloid (Aβ)—a toxic protein fragment that clumps outside neurons. The core is surrounded by damaged neuronal extensions, as well as reactive astrocytes and...
35
01:22Dementia l: Introduction
35
Dementia is an acquired, progressive syndrome characterized by a decline in multiple cognitive domains severe enough to impair daily functioning and reduce independence. Although memory loss is a central feature, the diagnosis requires additional deficits involving language, executive function, visuospatial skills, judgment, calculation, or abstract reasoning. These cognitive impairments reflect underlying neurodegenerative or vascular processes that gradually disrupt neuronal networks...
35