Hemostasis Abnormalities in Patients with Vascular Dementia and Alzheimer’s Disease

Abstract

SummarySince it has not been established to what extent abnormalities of hemostasis contribute to the occurrence and development of dementia, selected measurements of coagulation and fibrinolysis were obtained in elderly patients with Alzheimer’s disease (n = 22) or vascular dementia (n = 29), compared with healthy individuals in the same age range (n = 61). Hemostasis abnormalities were more frequent and marked in vascular dementia, being expressed as significant increases of plasminogen activator inhibitor type 1, von Willebrand factor, D-dimer. and activated factor VII. However, some hemostasis measurements (von Willebrand factor, activated factor VII) were abnormally high also in the patients with Alzheimer’s disease, a condition in which vascular damage is not considered to play a major pathogenetic role. It could not be established in this study whether or not these hemostatic abnormalities play a causal role in the pathogenesis of dementia, or whether they are secondary to inflammation and chronic vascular disease. Nevertheless, their presence may contribute to aggravating vascular disease.

Is Sticky Blood Bad for the Brain?

“…Our findings confirm those of several case-control studies showing that hemostatic markers are related to vascular dementia in particular, 4,6 and dementia in general. 2 Our findings extend this evidence to show prospectively over 17 years that hemostatic markers are associated with vascular dementia but not nonvascular dementia. Previous prospective evidence has shown that fibrinogen, but not CRP, was associated with vascular dementia.…”

“…1 There is limited case-control evidence associating markers of hemostasis and inflammation with dementia. [2][3][4][5][6] Limited prospective data come from the Rotterdam Study, which found that fibrinogen, but not C-reactive protein (CRP), was associated with incident dementia at the age of 6 years. 7 Therefore, further studies of hemostatic and inflammatory markers and risk of dementia (both vascular and nonvascular) are required.…”

Vascular Dementia Italian Sulodexide Study (VA.D.I.S.S.) Clinical and Biological Results

“…The existenceofa strong associationbetweenhighplasmafibrinogenlevelsand stroke (7,34), as well as the role of factor VII coagulantactivityas major risk factor for cardiovascularevents (35,36), is now well documented.Nevertheless,scantyis the knowledgeof the actual relevanceof altered hemostasisfactors on pathophysiologyof vasculardementia,as well as the impact of antithromboticdrugs on this condition. In a recent investigation,hemostasis abnormalitiessimilar to those found in patients with atherothromboticdiseaseswere observedin patientswith vasculardementia (37), suggestingthat these alterations can have a role in the pathogenesisof the disorder. In particular,highlevelsof activated Factor VII could be explainedif we assumethat vascular injury induces exposure of tissue factor thus acceleratingformationof activatedFactor VII/tissue factor pathway inhibitor (TFPI) complex.TFPI, a major inhibitorof activatedFactor VII, is releasedin plasmaby heparin and glycosaminoglycans (38), therefore, we might speculate that Sdx, a highly purified glicosaminoglycan preparation,by inducinga release of TFPI, influencesFactor VII zymogen levels.…”

Fibrinolysis and von Willebrand factor in Alzheimer's disease and vascular dementia – a case-referent study

“…Hemostasis has been proposed as a possible pathogenetic factor in dementia, especially vascular dementia [1][2][3]. To our knowledge there is only one study by Mari et al [1] in which endothelial derived fibrinolytic markers and vWF has been evaluated in AD vs. VaD patients.…”

“…To our knowledge there is only one study by Mari et al [1] in which endothelial derived fibrinolytic markers and vWF has been evaluated in AD vs. VaD patients.…”