Cerebrovascular Alterations in Alzheimer Disease

Abstract

Alzheimer’s disease, the leading cause of cognitive impairment in the elderly, has traditionally been considered a disease of neurons. Structural and function alterations of cerebral blood vessels also occur, but direct evidence of a causal involvement in the pathobiology of the disease has been lacking. This Viewpoint will review new data that may help shed light into the intriguing association between vascular and neurodegenerative pathology.

Keywords: Alzheimer disease; blood-brain barrier; dementia; neurons; risk factors.

Figure 1

AD pathology leads to dysfunction and damage to cerebral blood vessels by inducing vascular dysregulation, blood-brain barrier (BBB) disruption, and promoting atherosclerosis. In turn, poor vascular health promotes amyloid accumulation by increasing Aβ production and reducing its vascular clearance. The harmful effects of vascular and AD pathology converge on the brain to induce neuronal dysfunction and cognitive impairment.