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Alzheimer's disease: how does it start?

J C de la Torre1

  • 1UCSD-Neuropathology Division, 1363 Shinly, Suite 100, Escondido, CA 92026, USA. jdelator@nctimes.net

Journal of Alzheimer'S Disease : JAD
|January 8, 2003
PubMed

Insights

Alzheimer's disease (AD) is a vascular disorder, not neurodegenerative. Reclassifying AD as vascular could improve treatment by targeting relevant pathology.

Area of Science:

  • Neurology
  • Pathology
  • Epidemiology

Background:

  • Alzheimer's disease (AD) is currently misclassified as a neurodegenerative disorder.
  • When vascular lesions are present, AD is often categorized as vascular dementia.
  • Compelling evidence suggests AD is fundamentally a vascular disorder with secondary neurodegenerative effects.

Purpose of the Study:

  • To review evidence supporting the reclassification of Alzheimer's disease (AD) as a vascular disorder.
  • To address inconsistencies in AD research and treatment stemming from its current classification.
  • To propose new research directions for effective AD therapy.

Main Methods:

  • Comprehensive review of interdisciplinary evidence (epidemiology, pharmacology, neuroimaging, clinical medicine, pathology, physiology, experimental research).
  • Analysis of AD risk factors, clinical symptoms, and treatment outcomes in relation to vascular pathology.
  • Examination of historical challenges in AD diagnosis and preclinical marker identification.

Main Results:

  • Evidence from multiple disciplines supports AD as a vascular disorder.
  • This perspective explains treatment failures, links to vascular risk factors, and similarities with vascular dementia.
  • It also clarifies difficulties in preclinical neurodegenerative marker detection and paradoxical pathophysiological events.

Conclusions:

  • Reclassifying AD as a vascular disorder is crucial for advancing treatment strategies.
  • Focusing on relevant vascular pathology in clinical trials can improve therapeutic success.
  • New research lines targeting vascular mechanisms offer potential for novel AD therapies.

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