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Published on: November 6, 2017
Vascular pathology and pathogenesis of cognitive impairment and dementia in older adults
Sonal Agrawal1,2, Julie A Schneider1,2
1Rush Alzheimer's Disease Center, Rush University Medical Center, Jelke Building, 1750 W. Harrison Street, Chicago 60612, IL, USA.
Insights
Older brains often show cerebrovascular disease, impacting cognition and dementia risk. This review examines these pathologies, especially mixed neurodegenerative and vascular conditions, in aging populations.
Area of Science:
- Neurology
- Pathology
- Gerontology
Background:
- Cerebrovascular disease is common in older adults.
- Vascular pathologies are linked to cognitive impairment and dementia.
- Mixed pathologies (Alzheimer's/non-Alzheimer's and vascular) are crucial in aging brains.
Purpose of the Study:
- To review vascular pathologies, cognitive impairment, and dementia.
- To highlight the significance of mixed co-morbid pathologies.
- To present updated findings on vascular pathologies from specific cohorts.
Main Methods:
- Review of clinical pathologic studies, particularly community-based studies.
- Analysis of data from the Rush Memory and Aging Project and Religious Orders Study.
- Examination of neuropathological perspectives and emerging community-based data.
Main Results:
- Older individuals frequently exhibit cerebrovascular disease and related injuries.
- Mixed neurodegenerative and vascular pathologies are prevalent and significant.
- Age-related differences in vascular pathologies exist between individuals with and without dementia.
Conclusions:
- Vascular pathologies significantly contribute to cognitive impairment and dementia in aging.
- Understanding mixed pathologies is essential for interpreting clinical-pathologic findings.
- Continued research in community-based studies is vital for advancing knowledge on aging and dementia.
Abstract:
It is well recognized that brains of older people often harbor cerebrovascular disease pathology including vessel disease and vascular-related tissue injuries and that this is associated with vascular cognitive impairment and contributes to dementia. Here we review vascular pathologies, cognitive impairment, and dementia. We highlight the importance of mixed co-morbid AD/non-AD neurodegenerative and vascular pathology that has been collected in multiple clinical pathologic studies, especially in community-based studies. We also provide an update of vascular pathologies from the Rush Memory and Aging Project and Religious Orders Study cohorts with special emphasis on the differences across age in persons with and without dementia. Finally, we discuss neuropathological perspectives on the interpretation of clinical-pathological studies and emerging data in community-based studies.
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