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Where vascular meets neurodegenerative disease

Julie A Schneider1, David A Bennett

  • 1Department of Pathology and Neurological Sciences, Rush Alzheimer's Disease Center, Rush University Medical Center, Armour Academic Center, 600 S Paulina St, Suite 1022F, Chicago, IL 60612, USA. julie_a_schneider@rush.edu

Stroke
|September 30, 2010
PubMed

Insights

Vascular and Alzheimer's disease often coexist in older adults. Autopsy studies reveal that brain infarcts and vascular issues are common, contributing to cognitive decline and memory loss.

Area of Science:

  • Neurology
  • Gerontology
  • Pathology

Background:

  • Vascular and neurodegenerative diseases frequently co-occur in aging populations.
  • Distinguishing between clinical Alzheimer's disease and vascular contributions to cognitive impairment can be challenging.
  • Mixed pathologies are common in dementia in older adults.

Purpose of the Study:

  • To review findings on the interplay between vascular pathology and cognitive impairment in older persons.
  • To investigate the association between macroscopic infarcts, Alzheimer's disease pathology, and cognitive status.
  • To explore how vascular pathology may contribute to or be difficult to differentiate from Alzheimer's disease.

Main Methods:

  • Review of findings from longitudinal aging studies (Rush Religious Orders Study and Memory and Aging Project).
  • Enrollment of subjects without diagnosed dementia.
  • Annual clinical evaluations and post-mortem autopsies.

Main Results:

  • Macroscopic infarcts are prevalent and lower the threshold for cognitive impairment.
  • Vascular pathology frequently coexists with Alzheimer's disease pathology.
  • Vascular pathology is associated with memory impairment and can mimic clinical Alzheimer's disease.

Conclusions:

  • Dementia in older adults often results from mixed pathologies (vascular and Alzheimer's).
  • Clinical presentations of dementia can overlap due to mixed pathologies.
  • Some risk factors may increase Alzheimer's disease risk by exacerbating vascular pathology.

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