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Review
. 2014 Nov 11:12:206.
doi: 10.1186/s12916-014-0206-2.

The overlap between vascular disease and Alzheimer's disease--lessons from pathology

Johannes Attems  1 , Kurt A Jellinger
Affiliations
Review

The overlap between vascular disease and Alzheimer's disease--lessons from pathology

Johannes Attems et al. BMC Med. .

Abstract

Recent epidemiological and clinico-pathological data indicate considerable overlap between cerebrovascular disease (CVD) and Alzheimer's disease (AD) and suggest additive or synergistic effects of both pathologies on cognitive decline. The most frequent vascular pathologies in the aging brain and in AD are cerebral amyloid angiopathy and small vessel disease. Up to 84% of aged subjects show morphological substrates of CVD in addition to AD pathology. AD brains with minor CVD, similar to pure vascular dementia, show subcortical vascular lesions in about two-thirds, while in mixed type dementia (AD plus vascular dementia), multiple larger infarcts are more frequent. Small infarcts in patients with full-blown AD have no impact on cognitive decline but are overwhelmed by the severity of Alzheimer pathology, while in early stages of AD, cerebrovascular lesions may influence and promote cognitive impairment, lowering the threshold for clinically overt dementia. Further studies are warranted to elucidate the many hitherto unanswered questions regarding the overlap between CVD and AD as well as the impact of both CVD and AD pathologies on the development and progression of dementia.

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Figures

Figure 1
Figure 1
Pathogenic factors for the development of mixed dementia. Modified from [147].
See this image and copyright information in PMC

References

    1. Petrovitch H, Ross GW, Steinhorn SC, Abbott RD, Markesberry W, Davis DG, Nelson J, Hardman J, Masaki KH, Vogt MR, Launer LJ, White LR. AD lesions and infarcts in demented and no-demented Japanese-American men. Ann Neurol. 2005;57:98–103. doi: 10.1002/ana.20318. - DOI - PubMed
    1. Jellinger KA. The enigma of vascular cognitive disorder and vascular dementia. Acta Neuropathol. 2007;113:349–388. doi: 10.1007/s00401-006-0185-2. - DOI - PubMed
    1. Jellinger KA. The enigma of mixed dementia. Alzheimers Dement. 2007;3:40–53. doi: 10.1016/j.jalz.2006.09.002. - DOI - PubMed
    1. Schneider JA, Arvanitakis Z, Bang W, Bennett DA. Mixed brain pathologies account for most dementia cases in community-dwelling older persons. Neurology. 2007;69:2197–2204. doi: 10.1212/01.wnl.0000271090.28148.24. - DOI - PubMed
    1. Toledo JB, Arnold SE, Raible K, Brettschneider J, Xie SX, Grossman M, Monsell SE, Kukull WA, Trojanowski JQ. Contribution of cerebrovascular disease in autopsy confirmed neurodegenerative disease cases in the National Alzheimer’s Coordinating Centre. Brain. 2013;136:2697–2706. doi: 10.1093/brain/awt188. - DOI - PMC - PubMed

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