Late and early onset dementia: What is the role of vascular factors? A retrospective study

Carotenuto, Anna; Rea, Raffaele; Colucci, Luisa; Ziello, Antonio Rosario; Molino, Ivana; Carpi, Sabrina; Traini, Enea; Amenta, Francesco; Fasanaro, Angiola Maria

doi:10.1016/j.jns.2012.07.066

Cited by 23 publications

(12 citation statements)

References 21 publications

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“…In the present study, the EOAD was not associated with major VRF, consistent with a previous report which has shown that VRFs are less prevalent in EOAD than in late-onset AD [ 26 ].…”

Section: Discussionsupporting

confidence: 93%

Low Prevalence and Clinical Effect of Vascular Risk Factors in Early-Onset Alzheimer’s Disease

Chen

Sillaire

Dallongeville

et al. 2017

JAD

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Background:Determinants of early-onset Alzheimer’s disease (EOAD) are not well known. In late-onset AD, vascular risk factors (VRFs) are associated with earlier clinical manifestation.Objective:The objective of this study was to assess the putative association between VRFs and EOAD.Methods:We studied participants with dementia meeting criteria for EOAD (recruited into the French CoMAJ prospective cohort study from 1 June 2009 to 28 February 2014) and age-, gender-matched controls (ratio 1:3, drawn randomly from the French MONA-LISA population-based survey between 2005 and 2007). Demographic data, VRFs, comorbidities, treatments, and APOE genotypes were compared in multivariable logistic regression analyses.Results:We studied 102 participants with dementia (mean±standard deviation age: 59.5±3.8; women: 59.8%) and 306 controls. Compared with controls, EOAD participants had spent less time in formal education (9.9±2.9 versus 11.7±3.8 y; p < 0.0001), were less likely to be regular alcohol consumers (p < 0.0001), had a lower body mass index (–2 kg/m2; p < 0.0004), and a lower mean systolic blood pressure (–6.2 mmHg; p = 0.0036). The prevalence of APOE ɛ4 allele was higher in participants with dementia than in controls (50% versus 29.4%; p = 0.0002), as was the prevalence of depression (48% versus 32%; p < 0.001). Similar results were observed in multivariable analysis. Compared with EOAD participants lacking VRFs, EOAD participants with at least one VRF had a higher prevalence of depression (29.6% versus 53.3%, respectively; p = 0.03).Conclusion:The prevalence of VRFs is not elevated in EOAD patients (in contrast to older AD patients). Extensive genetic testing should be considered more frequently in the context of EOAD.

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“…In the present study, the EOAD was not associated with major VRF, consistent with a previous report which has shown that VRFs are less prevalent in EOAD than in late-onset AD [ 26 ].…”

Section: Discussionsupporting

confidence: 93%

Low Prevalence and Clinical Effect of Vascular Risk Factors in Early-Onset Alzheimer’s Disease

Chen

Sillaire

Dallongeville

et al. 2017

JAD

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“…Cerebrovascular lesions are found in the majority of late-onset AD and only in half of early-onset AD cases [160]. There are considerable differences in the pathological burden in relation to age of onset of dementia, suggesting that late onset is associated with increased vascular pathology and lower AD burden [161],[162].…”

Section: Reviewmentioning

confidence: 99%

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

Attems

Jellinger

2014

BMC Med

582

420

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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.Electronic supplementary materialThe online version of this article (doi:10.1186/s12916-014-0206-2) contains supplementary material, which is available to authorized users.

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“…Patients, diagnosed according to NINCDS-ADRDA criteria, were all in a mild/moderate-stage, showed brain ischemic lesions (in CT or MRI), and had at least two vascular risk factors (such as hypertension, diabetes, obesity, ischemic heart disease, hypercholesterolemia, hyperhomocysteinemia, smoking, previous cerebrovascular events, or family history of cardio-cerebrovascular diseases). This to confirm the diagnosis of cerebrovascular impairment [37,38]. Two matched groups were analyzed: one (group A) treated with donepezil 10 mg/day plus choline alphoscerate 1,200 mg/day (associative therapy), the other (group B) with donepezil 10 mg/day + placebo (mono therapy).…”

Section: Patients and Study Typementioning

confidence: 99%

The Effect of the Association between Donepezil and Choline Alphoscerate on Behavioral Disturbances in Alzheimer’s Disease: Interim Results of the ASCOMALVA Trial

Carotenuto

Rea

Traini

et al. 2017

JAD

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Late and early onset dementia: What is the role of vascular factors? A retrospective study

Cited by 23 publications

References 21 publications

Low Prevalence and Clinical Effect of Vascular Risk Factors in Early-Onset Alzheimer’s Disease

Low Prevalence and Clinical Effect of Vascular Risk Factors in Early-Onset Alzheimer’s Disease

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

The Effect of the Association between Donepezil and Choline Alphoscerate on Behavioral Disturbances in Alzheimer’s Disease: Interim Results of the ASCOMALVA Trial

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