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Hemostatic Abnormalities in Dementia: A Systematic Review and Meta-Analysis
Cristina de Mello Gomide Loures1, Rita Carolina Figueiredo Duarte1, Marcos Vinícius Ferreira Silva1
1Department of Clinical and Toxicological Analysis, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Seminars in Thrombosis and Hemostasis
|May 17, 2019
Summary
This study found that Alzheimer's disease (AD) and vascular dementia (VD) involve distinct changes in blood clotting and endothelial function markers. Understanding these hemostatic differences is key for diagnosing and treating cognitive decline in the elderly.
Area of Science:
- Neuroscience
- Gerontology
- Hematology
Background:
- Alzheimer's disease (AD) is the leading cause of dementia in the elderly.
- Vascular risk factors are implicated in the development and progression of dementia.
- Alterations in vascular walls are observed in patients with AD and other dementias.
Purpose of the Study:
- To systematically review and meta-analyze observational studies on the hemostatic system's contribution to cognitive decline.
- To compare hemostatic markers in patients with Alzheimer's disease (AD), vascular dementia (VD), and cognitively healthy individuals.
Main Methods:
- Systematic review and meta-analysis of observational studies.
- Literature search until April 2018 across multiple databases (Medline, Scopus, Web of Science, etc.).
- Inclusion of studies examining hemostatic markers in elderly individuals with or without cognitive impairment.
Main Results:
- AD patients showed elevated plasma levels of von Willebrand factor (VWF), D-dimer, plasminogen activator inhibitor-1, thrombomodulin, and homocysteine.
- VD patients exhibited increased fibrinogen, activated factor VII, factor VIII, VWF, D-dimer, and homocysteine levels.
- AD was associated with markers of endothelial dysfunction, while VD involved coagulation cascade components.
Conclusions:
- The hemostatic system plays a significant role in cognitive decline associated with AD and VD.
- Distinct hemostatic profiles differentiate AD from VD, suggesting different underlying pathophysiological mechanisms.
- These findings highlight potential therapeutic targets for managing dementia subtypes.
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