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Alzheimer's Disease and Cardiovascular Disease: A Particular Association
Giacomo Tini1, Riccardo Scagliola1, Fiammetta Monacelli2,3
1Department of Internal Medicine (DIMI) Clinic of Cardiovascular Diseases, University of Genoa, Genoa, Italy.
Insights
Alzheimer's disease (AD) and cardiovascular disease (CVD) are frequently linked. Understanding the impact of CVD on AD is crucial for better brain health outcomes and clarifying underlying mechanisms.
Area of Science:
- Neurology
- Cardiology
- Public Health
Background:
- Alzheimer's disease (AD) and cardiovascular diseases (CVD) are significant global health concerns.
- The co-occurrence of AD and CVD presents a complex clinical challenge.
- Understanding the interplay between these conditions is vital for effective management and prevention.
Purpose of the Study:
- To review the existing literature on the association between Alzheimer's disease and cardiovascular diseases.
- To explore potential mechanisms linking AD and CVD.
- To identify gaps in knowledge regarding the impact of CVD on AD.
Main Methods:
- A comprehensive literature search was conducted in MEDLINE (PubMed), EMBASE, and Clinical Trials databases from January 1980 to May 2019.
- Search terms included "Alzheimer's disease" combined with various cardiovascular conditions and risk factors.
- Ninety-eight community-based studies meeting specific inclusion criteria were selected for analysis.
Main Results:
- Alzheimer's disease and cardiovascular diseases are frequently associated.
- Potential mechanisms include hypoperfusion, emboli, atherosclerosis, and shared amyloid pathology in the brain and heart.
- The exact impact of vascular factors and their underlying mechanisms requires further elucidation.
Conclusions:
- Further research is necessary to fully understand the effect of CVD and its risk factors on AD.
- Clarifying the impact of subclinical and clinical CVD on the brain is essential.
- Investigating the hypothesized mechanisms and gender-specific issues in the AD-CVD association is warranted.
Methods:
This review is based on the material obtained via MEDLINE (PubMed), EMBASE, and Clinical Trials databases, from January 1980 until May 2019. The search term used was "Alzheimer's disease," combined with "cardiovascular disease," "hypertension," "dyslipidaemia," "diabetes mellitus," "atrial fibrillation," "coronary artery disease," "heart valve disease," and "heart failure." Out of the 1,328 papers initially retrieved, 431 duplicates and 216 records in languages other than English were removed. Among the 681 remaining studies, 98 were included in our research material on the basis of the following inclusion criteria: (a) the community-based studies; (b) using standardized diagnostic criteria; (c) reporting raw prevalence data; (d) with separate reported data for sex and age classes.
Results:
While AD and CVD alone may be considered deleterious to health, the study of their combination constitutes a clinical challenge. Further research will help to clarify the real impact of vascular factors on these diseases. It may be hypothesized that there are various mechanisms underlying the association between AD and CVD, the main ones being hypoperfusion and emboli, atherosclerosis, and the fact that, in both the heart and brain of AD patients, amyloid deposits may be present, thus causing damage to these organs.
Conclusions:
AD and CVD are frequently associated. Further studies are needed in order to understand the effect of CVD and its risk factors on AD in order to better comprehend the effects of subclinical and clinical CVD on the brain. Finally, we need to clarify the impact of the underlying hypothesized mechanisms of this association and to investigate gender issues.
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