Related Experiment Video

Updated: Jul 18, 2026

Lesion Explorer: A Video-guided, Standardized Protocol for Accurate and Reliable MRI-derived Volumetrics in Alzheimer's Disease and Normal Elderly
12:50

Lesion Explorer: A Video-guided, Standardized Protocol for Accurate and Reliable MRI-derived Volumetrics in Alzheimer's Disease and Normal Elderly

Published on: April 14, 2014

Cognitive impact of subcortical vascular and Alzheimer's disease pathology

Helena C Chui1, Chris Zarow, Wendy J Mack

  • 1Department of Neurology, University of Southern California, Los Angeles, USA. chui@usc.edu

Annals of Neurology
|December 29, 2006
PubMed

Insights

Alzheimer's disease pathology significantly impacts cognitive status, often overshadowing cerebrovascular disease and hippocampal sclerosis. Apolipoprotein E4 genotype is linked to Alzheimer's but not other pathologies.

Area of Science:

  • Neuropathology
  • Neurodegenerative Diseases
  • Cognitive Neurology

Background:

  • Subcortical ischemic vascular disease and Alzheimer's disease (AD) often coexist.
  • Understanding the interplay of different pathologies is crucial for diagnosing cognitive impairment.

Purpose of the Study:

  • To investigate the independent and interactive effects of cerebrovascular disease, hippocampal sclerosis (HS), and AD pathology on cognitive status.
  • To examine the association of apolipoprotein E (APOE) genotype with these pathologies and cognitive function.

Main Methods:

  • Analysis of 79 autopsy cases from a longitudinal study on subcortical ischemic vascular disease and AD.
  • Ordinal logistic regression models were used to assess the contribution of each pathology to cognitive status, including interaction terms.
  • Correlation analysis was performed for APOE genotype with specific neuropathological findings.

Main Results:

  • Significant AD pathology was present in 54% of cases, cerebrovascular parenchymal pathology scores (CVDPS) in 30%, and HS in 18%.
  • Braak and Braak stage (AD pathology), HS score, and CVDPS independently predicted cognitive status.
  • APOE e4 genotype was associated with AD pathology (Braak stage) but not with CVDPS or HS.

Conclusions:

  • HS is a common, often unsuspected, finding in brains with cerebrovascular disease.
  • While CVDPS and HS contribute to cognitive impairment, advanced AD pathology is the primary determinant of dementia.
  • APOE e4 genotype is associated with cerebral amyloid angiopathy, a component of AD, rather than HS or arteriosclerosis.
Abstract

More Related Videos

Using Retinal Imaging to Study Dementia09:17

Using Retinal Imaging to Study Dementia

Published on: November 6, 2017

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions07:30

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

Published on: April 23, 2021

Related Concept Videos

Dementia l: Introduction01:22

Dementia l: Introduction

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...
Alzheimer Disease ll: Pathophysiology01:23

Alzheimer Disease ll: Pathophysiology

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 microglia. Abnormal...
Alzheimer Disease l: Introduction01:29

Alzheimer Disease l: Introduction

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...
Alzheimer's Disease: Overview01:26

Alzheimer's Disease: Overview

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 and tau...
Cerebral Edema ll: Pathophysiology01:22

Cerebral Edema ll: Pathophysiology

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 barrier loses...
Dementia01:30

Dementia

Dementia is a collective term for cognitive disorders primarily affecting memory, thinking, and reasoning. It is not a specific disease but a syndrome, with Alzheimer's disease being the most common cause, accounting for approximately 60-80% of cases. Other types include vascular dementia, Lewy body dementia, and frontotemporal dementia. Dementia affects millions worldwide, particularly older adults, though it is not a normal part of aging.
The progression of dementia is generally gradual.