Penn Study Shows Vascular Link in Alzheimer's Disease with Cognition

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Media Contact:Kim Menard | Kim.Menard@uphs.upenn.edu | 215-662-6183July 9, 2013

Researchers in the Perelman School of Medicine at the University of Pennsylvania found that, across a variety of neurodegenerative diseases, cerebrovascular disease affecting circulation of blood in the brain was significantly associated with dementia. The researchers contend that people already exhibiting clinical features of Alzheimer's disease and other memory impairments may benefit from effective therapies currently available to reduce vascular problems. Thus, early management of vascular risk factors, such as high blood pressure and cholesterol, and adopting a 'heart healthy' diet as well as exercise and other lifestyles in midlife may delay or prevent the onset of dementia due to  Alzheimer's and Parkinson's disease. 

The link between cerebrovascular disease was strongest with Alzheimer's disease – as compared to other neurodegenerative diseases including frontotemporal lobar degeneration, Lou Gehrig’s disease or ALS and Parkinson's disease – and had the most pronounced effect in younger Alzheimer's patients, according to the study, published in the July 10 issue of Brain.

"While there was evidence already to suggest that vascular disease could play a role in neurodegenerative disease, this is the first study to compare the burden of vascular disease across neurodegenerative diseases with multiple, distinct or different origins," said senior author John Q. Trojanowski, MD, PhD, director of the National Institute on Aging-funded Alzheimer's Disease Core Center at the University of Pennsylvania and professor of Pathology and Laboratory Medicine. "We were surprised to find such a strong link to vascular disease in Alzheimer's disease, especially in younger patients, in comparison to individuals with other neurodegenerative diseases."

Penn researchers analyzed 5715 cases from the National Alzheimer's Coordinating Center (NACC) database, which have been collected from 35 past and present NIA-funded Alzheimer’s centers across the US since NACC was started in 1999. This is the first study to compare the presence of cerebrovascular disease across the whole spectrum of neurogenerative diseases.

Nearly 80 percent of the more than 4600 Alzheimer's disease patients showed some degree of vascular pathology – defined as hardened or blocked blood vessels, tissue death due to lack of blood supply, or bleeding – in the brain, as compared to 67 percent in the control group of people with no remarkable brain disease pathology, and 66 percent in the Parkinson's pathology group.

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