Alzheimer's disease prevalence can be lowered with non-invasive testing

Cardiovascular and cerebrovascular disease are reported to be major risk factors to Alzheimer's disease (AD). These risk factors mainly affect the elderly (over age 60) and previously were believed to only promote vascular dementia (VaD). Cardiovascular and cerebrovascular pathology involving structural lesions of the heart and carotid or vertebral artery stenosis stemming from intima media thickening or vessel plaque formation can insidiously reduce blood flow to the brain. Since heart and carotid artery disease are common findings in elderly patients and can provoke chronic cerebral hypoperfusion, we submit that individuals with even very mild memory complaints should undergo screening using echocardiography and carotid Doppler ultrasound. These non-invasive, safe, cost-effective ultrasound techniques can often detect correctable or treatable early lesions involving the carotid arteries and the heart that contribute to cerebral hypoperfusion. Inasmuch as cerebral hypoperfusion can be a pathophysiologic trigger of AD, its prevention or attenuation should tangibly reverse or at least delay the onset and impact of severe cognitive meltdown. This clinical approach may have an important impact in reducing the number of new AD and VaD cases and lessen the catastrophic socio-economic burden these dementias are expected to have on the US healthcare system in the near future.