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Alzheimer's, Dementia & Mental Health
Dementia Less Likely with Improved Efforts to
Prevent Vascular Disease
Study finds mix of disease in dementia
brains, often Alzheimer’s and stroke
 June 14, 2007 - Few older people die with brains
untouched by a pathological process, however, an individual’s likelihood
of having clinical signs of dementia increases with the number of
different disease processes present in the brain, according to a new
study. Alzheimer’s disease and stroke are the most common mix.
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The research was funded by the National Institute
on Aging (NIA), part of the National Institutes of Health, and conducted
at the Rush Alzheimer’s Disease Center at Rush University Medical Center
in Chicago. Julie Schneider, M.D., and colleagues report the findings in
the journal Neurology online today.
Among their findings is the observation that the
combination of Alzheimer’s disease and cerebral infarcts (strokes) is
the most common mix of pathologies in the brains of people with
dementia. The implication of these findings is that public health
efforts to prevent and treat vascular disease could potentially reduce
the occurrence of dementia, the researchers say in the paper.
The researchers used data from the Rush Memory and
Aging Project—an ongoing study of 1,200 elderly volunteers who have
agreed to be evaluated every year and to donate their brains upon death.
The current study compared clinical and autopsy data on the first 141
participants who have died.
Annual physical and psychological exams showed
that, while they were alive, 50 of the 141 had dementia. Upon death, a
neuropathologist, who was unaware of the results of the clinical
evaluation, analyzed each person’s brain. The autopsies showed that
about 85 percent of the individuals had evidence of at least one chronic
disease process, such as Alzheimer’s disease, strokes, Parkinson’s
disease, hemorrhages, tumors, traumatic brain injury or others.
Comparison of the clinical and autopsy results
showed that only 30 percent of people with signs of dementia had
Alzheimer’s disease alone.
By contrast, 42 percent of the people with dementia
had Alzheimer’s disease with infarcts and 16 percent had Alzheimer’s
disease with Parkinson’s disease (including two people with all three
conditions).
Infarcts alone caused another 12 percent of the
cases. Also, 80 of the 141 volunteers who died had sufficient
Alzheimer’s disease pathology in their brains to fulfill accepted
neuropathologic criteria for Alzheimer’s disease, although in life only
47 were clinically diagnosed with probable or possible Alzheimer’s
disease.
“We know that people can have Alzheimer’s pathology
without having symptoms,” says Dallas Anderson, Ph.D., population
studies program director in the NIA Neuroscience and Neuopsychology of
Aging Program. “The finding that Alzheimer’s pathology with cerebral
infarcts is a very common combination in people with dementia adds to
emerging evidence that we might be able to reduce some of the risk of
dementia with the same tools we use for cardiovascular disease such as
control of blood cholesterol levels and hypertension.”
NIA is conducting clinical trials to determine
whether interventions for cardiovascular disease can prevent or slow the
progress of Alzheimer’s disease. On-going trials cover a range of
interventions such as statin drugs, vitamins and exercise.
Editor’s Notes:
NIA leads the federal effort supporting and
conducting research on aging and the medical, social and behavioral
issues of older people, including Alzheimer’s disease and age-related
cognitive decline. For information on dementia and aging, please visit
NIA’s Alzheimer’s Disease Education and Referral Center at
http://www.nia.nih.gov/alzheimers, or call 1-800-438-4380.
For more general information on research and aging,
go to
http://www.nia.nih.gov.
NIH—the nation’s medical research
agency—includes 27 institutes and centers and is a component of the U.S.
Department of Health and Human Services. It is the primary federal
agency for conducting and supporting basic, clinical and translational
medical research, and it investigates the causes, treatments and cures
for both common and rare diseases. For more information about NIH and
its programs, visit
http://www.nih.gov.
Reference: JA Schneider et al. Mixed Brain
Pathologies Account for Most Dementia Cases in Community-Dwelling Older
Persons. Neurology (2007). DOI: 10.1212/01.wnl.0000271090.28148.24
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