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Using Retinal Imaging to Study Dementia
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Published on: November 6, 2017

Contribution of vascular pathology to the clinical expression of dementia

Dorothea Strozyk1, Dennis W Dickson, Richard B Lipton

  • 1Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, 1300 Morris Park Avenue, Bronx, NY 10461, USA.

Neurobiology of Aging
|November 11, 2008
PubMed

Insights

Brain vascular lesions, including leukoencephalopathy and large infarcts, are linked to dementia and its subtypes. A higher overall vascular burden also correlates with cognitive decline in older adults.

Area of Science:

  • Neurology
  • Neuroscience
  • Pathology

Background:

  • Vascular lesions in the brain are common in aging populations.
  • The specific impact of different types of postmortem vascular lesions on antemortem cognitive status remains unclear.

Purpose of the Study:

  • To investigate the association between six types of brain vascular lesions and cognitive diagnoses (dementia, Alzheimer's disease, vascular dementia).
  • To develop and evaluate a summary score for macroscopic vascular lesions to assess cumulative impact on cognition.

Main Methods:

  • Analysis of autopsy data from 190 older adults.
  • Examination of six vascular lesions: large infarcts, lacunar infarcts, leukoencephalopathy, microinfarcts, cribriform changes, and cerebral amyloid angiopathy.
  • Development of a vascular score based on large infarcts, lacunar infarcts, and leukoencephalopathy.

Main Results:

  • Sixty-eight percent of cases exhibited vascular lesions.
  • Leukoencephalopathy was significantly associated with dementia (OR 3.5).
  • Large infarcts were significantly associated with vascular dementia (OR 4.3).
  • The vascular score showed associations with dementia (OR 1.6), Alzheimer's disease (OR 1.5), and vascular dementia (OR 2.0).

Conclusions:

  • Leukoencephalopathy and large infarcts are independently associated with dementia and vascular dementia, respectively.
  • A cumulative burden of macroscopic vascular lesions is associated with the clinical expression of dementia and its subtypes.
  • Findings highlight the importance of vascular pathology in the pathogenesis of cognitive impairment in aging.

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