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Titre du document / Document title

The role of cerebral ischemia in Alzheimer's disease

Auteur(s) / Author(s)

KALARIA R. N. (1 2) ;

Affiliation(s) du ou des auteurs / Author(s) Affiliation(s)

(1) Wolfson Research Centre, Institute for Health of the Elderly, Newcastle General Hospital, Westgate Road, Newcastle upon Tyne, NE4 6BE, ROYAUME-UNI
(2) Department of Psychiatry, University of Newcastle, Newcastle upon Tyne, NE1 4LP, ROYAUME-UNI

Résumé / Abstract

The Alzheimer type of dementia and stroke are known to increase at comparable rates with age. Recent advances suggest that vascular risk factors linked to cerebrovascular disease and stroke in the elderly significantly increase the risk of developing Alzheimer's disease (AD). These include atherosclerosis, atrial fibrillation, coronary artery disease, hypertension, and diabetes mellitus. Moreover, review of various autopsy series shows that 60-90% of AD cases exhibit variable cerebrovascular pathology. Although some vascular lesions such as cerebral amyloid angiopathy, endothelial degeneration, and periventricular white matter lesions are evident in most cases of AD, a third will exhibit cerebral infarction. Despite the interpretation of pathological evidence, longitudinal clinical studies suggest that the co-existence of stroke and AD occurs more than by chance alone. Strokes known to occur in patients with Alzheimer syndrome and most frequently in the oldest old substantially worsen cognitive decline and outcome, implicating some interaction between the disorders. Nevertheless, the nature of a true relationship between the two disorders seems little explored. What predisposes to strokes in underlying cognitive decline or AD? Is it possible that cerebral ischemia is a causal factor for AD? I examined several vascular factors and the vascular pathophysiology implicated in stroke and AD, and propose that cerebral ischemia or oligemia may promote Alzheimer type of changes in the aging brain. Irrespective of the ultimate pathogenetic mechanism, these approaches implicate that management of peripheral vascular disease is important in the treatment or prevention of Alzheimer's disease or mixed dementia.

Revue / Journal Title

Neurobiology of aging    ISSN  0197-4580   CODEN NEAGDO 

Source / Source

2000, vol. 21, no2, pp. 321-330 (90 ref.)

Langue / Language

Anglais

Editeur / Publisher

Elsevier, London, ROYAUME-UNI  (1980) (Revue)

Mots-clés anglais / English Keywords

Brain (vertebrata)

;

Cerebrovascular disease

;

Risk factor

;

Alzheimer disease

;

Ischemia

;

Human

;

Nervous system diseases

;

Central nervous system disease

;

Cerebral disorder

;

Degenerative disease

;

Cardiovascular disease

;

Vascular disease

;

Mots-clés français / French Keywords

Encéphale

;

Cérébrovasculaire pathologie

;

Facteur risque

;

Démence Alzheimer

;

Ischémie

;

Homme

;

Système nerveux pathologie

;

Système nerveux central pathologie

;

Encéphale pathologie

;

Maladie dégénérative

;

Appareil circulatoire pathologie

;

Vaisseau sanguin pathologie

;

Mots-clés espagnols / Spanish Keywords

Encéfalo

;

Vaso sanguíneo encéfalo patología

;

Factor riesgo

;

Demencia Alzheimer

;

Isquemia

;

Hombre

;

Sistema nervioso patología

;

Sistema nervosio central patología

;

Encéfalo patología

;

Enfermedad degenerativa

;

Aparato circulatorio patología

;

Vaso sanguíneo patología

;

Localisation / Location

INIST-CNRS, Cote INIST : 20387, 35400009005381.0180

Nº notice refdoc (ud4) : 1451685



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