Vascular and Alzheimer Disease in Dementia

Abstract

Gustavsson et al 1 recently showed that midlife atherosclerosis is related to vascular dementia and small vessel disease but not to Alzheimer-type dementia (AD) in the Swedish population-based Malmö Diet and Cancer Study. Although AD is frequently cited as the most common type of dementia, the relative contributions of vascular and neurodegenerative pathology to clinical dementia have not been clear. These separations are, however, important because they have direct implications for prevention. Although "pure" AD still defies causal treatment, there are possibilities for vascular prevention.We have earlier compared results from a systematic review of studies reporting clinicopathological data of dementia cases 2 and detailed death records of vascular comorbidity with dementia in the 49-year follow-up of older men (Helsinki Businessmen Study [HBS]). 3 This comparison 4 suggested that pure AD would comprise only one-quarter of all dementia cases in older age. The proportions of "pure" vascular dementia in neuropathological studies (26%) and vascular dementia in the HBS (22.5%) were also quite close. We have now added data from dementia types in the Swedish study, and the distributions show remarkable similarity (Table).In the HBS, we examined dementia diagnosis in older age in relation to vascular risk factors measured in midlife, at a median age of 42 years. In multivariate adjusted analyses, only serum cholesterol was significantly associated with dementia with vascular features, whereas none of the midlife vascular risk factors were related to pure AD-findings supporting the Swedish study. 1 The relationship of midlife cholesterol that was specific to vascular-type dementia may also shed light on the results of a further recent study 5 using Mendelian randomization (MR); in agreement with observational findings, genes encoding targets of several lipid-lowering drug classes were not related to diagnosis of AD (not separating pure and mixed types) in people aged 70 years and older. Further explanation may be selection bias associated with MR studies, especially for earlier and later developing health conditions that have shared etiology.

Impact of the Severities of Glaucoma on the Incidence of Subsequent Dementia: A Population-Based Cohort Study

“…Regarding other risk factors of dementia, several cardiovascular diseases lead to a higher rate of dementia development, which may due to the correlation of vessel damage and brain degeneration proven in previous research [1,7,8,23]. Besides, DM is associated with the occurrence of cardiovascular disease and can also lead to certain types of dementia, which correlated to the finding of the current study [9].…”

“…The associated co-morbidities and environmental risk factors are not uncommon in subjects with dementia [1,6]. Systemic vascular diseases are significantly correlated to dementia development [7], and cerebrovascular disease itself can lead to the onset of vascular dementia (VD) [1,8]. The presence of diabetes mellitus (DM) was associated with vascular dementia and Alzheimer's disease (AD) in a previous study [9].…”

Genetically Predicted Telomere Length and Its Relationship With Alzheimer’s Disease

“…Their functions are assumed to be stabilizing the structures of chromosomes and protecting the end of chromosomes from fusion with adjacent ones (Blackburn et al, 2015). Although dementia has unknown causes (Boyle et al, 2019;Morbelli et al, 2019;Ohara et al, 2019;Tropea et al, 2019;George et al, 2020;Iversen et al, 2020;Lu et al, 2020;Martinez-Miller et al, 2020;Mueller et al, 2020;Nadim et al, 2020;Osler et al, 2020;Scarioni et al, 2020;Seblova et al, 2020;Strandberg et al, 2020), several previous studies, including epidemiological surveys and clinical reports, showed that telomeres were shorter in patients with Alzheimer's disease (AD), cognitive disorders, other aging-related diseases, and mortality (Panossian et al, 2003;Franco et al, 2006;Thomas et al, 2008;Lukens et al, 2009;Zekry et al, 2010;Guan et al, 2012;Hochstrasser et al, 2012;Honig et al, 2012;Moverare-Skrtic et al, 2012;Takata et al, 2012;Mathur et al, 2014;Kota et al, 2015;Tedone et al, 2015;Zhan et al, 2015Zhan et al, , 2018aStaffaroni et al, 2018;Wang et al, 2018;Hagg, 2018, 2020;Gao et al, 2019;Guo and Yu, 2019;Kaja et al, 2019;Subedi et al, 2019;El Assar et al, 2020;…”

SM22α Deletion Contributes to Neurocognitive Impairment in Mice through Modulating Vascular Smooth Muscle Cell Phenotypes

“…Unfortunately, despite hundreds of research studies over recent decades, there is no cure in sight. Considerable evidence now indicates that diseases with cognitive impairment, such as Alzheimer’s disease (AD), which is primarily a vascular disorder that precedes neuronal dysfunction, could be prevented or delayed by targeting the vascular component [ 3 , 4 , 5 , 6 ].…”