Is Alzheimer's disease a homogeneous disease entity?

Area of Science:

• Neurology
• Neuroscience
• Geriatrics

Background:

• Dementia, particularly Alzheimer's disease (AD) and vascular dementia (VaD), poses a significant public health challenge.
• Historically, AD and VaD have been researched as distinct entities: neurodegenerative versus extrinsic brain damage.
• Recent advancements in biomarkers, neuroimaging, and cerebrospinal fluid analysis have improved the identification of pathological changes in both AD and VaD.

Purpose of the Study:

• To critically evaluate the prevailing concept of Alzheimer's disease (AD) as a singular disorder.
• To examine the consequences of treating AD and vascular dementia (VaD) as homogenous entities in research and therapeutic development.
• To challenge the dichotomy in research approaches for AD and VaD.

Main Methods:

• Literature review and conceptual analysis of current research paradigms in dementia.
• Comparative analysis of research methodologies applied to Alzheimer's disease (AD) and vascular dementia (VaD).
• Discussion of the implications of treating AD and VaD as distinct, uniform conditions.

Main Results:

• Vascular dementia (VaD) is recognized as a heterogeneous condition, unlike the traditional view of Alzheimer's disease (AD) as a single entity.
• Research and therapeutic development for sporadic VaD do not utilize models like CADASIL, whereas early-onset AD is used for sporadic AD therapy.
• The current research approach creates a "false concept" that hinders progress in understanding and treating dementia.

Conclusions:

• The conceptualization of Alzheimer's disease (AD) as a single, uniform disorder is problematic and requires re-evaluation.
• Treating vascular dementia (VaD) as a heterogeneous entity while viewing AD as singular leads to disparate research and treatment strategies.
• A paradigm shift is needed to address the heterogeneity within both AD and VaD for more effective dementia therapies.