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Aggregate effects of vascular risk factors on cerebrovascular changes in autopsy-confirmed Alzheimer's disease

Katherine J Bangen1, Daniel A Nation2, Lisa Delano-Wood3

  • 1Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|July 16, 2014
PubMed

Insights

Multiple vascular risk factors, not individual ones, correlate with cerebrovascular changes (CVCs) in Alzheimer's patients. CVCs were linked to less severe Alzheimer's pathology, suggesting vascular health impacts dementia progression.

Area of Science:

  • Neurology
  • Pathology
  • Gerontology

Background:

  • Alzheimer's disease (AD) is a leading cause of dementia.
  • Vascular risk factors are implicated in cognitive decline.
  • The interplay between vascular pathology and AD neuropathology requires further investigation.

Purpose of the Study:

  • To investigate the association between antemortem vascular risk factors and postmortem cerebrovascular changes (CVCs) and Alzheimer's disease (AD) pathologies.
  • To determine if aggregate vascular risk influences CVCs and AD severity.

Main Methods:

  • Eighty-four AD patients' antemortem vascular risk factors were assessed.
  • Postmortem brain autopsies were performed to evaluate CVCs (atherosclerosis, arteriosclerosis, lacunes, microinfarcts) and Braak stage.
  • Individuals with large strokes were excluded to focus on mild CVCs.

Main Results:

  • No single vascular risk factor, excluding stroke/TIA history, was linked to CVCs.
  • A higher number of vascular risk factors was significantly associated with the presence of CVCs.
  • CVCs were associated with a lower Braak and Braak stage, indicating less neurofibrillary tangle pathology.

Conclusions:

  • Aggregate vascular risk is crucial in the vascular contribution to dementia.
  • Maintaining cerebrovascular health may be key to preventing or delaying dementia, even in the presence of AD pathology.
  • These findings underscore the importance of managing multiple vascular risk factors for brain health in aging populations.

Keywords:
Alzheimer's diseaseCerebrovascular diseaseDementiaNeuropathologyVascular risk

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