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Atherosclerosis, Hypertension, and Diabetes in Alzheimer's Disease, Vascular Dementia, and Mixed Dementia : Prevalence and Presentation

Javanshiri, Keivan LU ; Waldö, Maria Landqvist LU ; Friberg, Niklas LU ; Sjövall, Fredrik LU ; Wickerström, Karin; Haglund, Mattias LU and Englund, Elisabet LU (2018) In Journal of Alzheimer's Disease 65(4). p.1247-1258
Abstract

Background: Alzheimer's disease (AD) is the most prevalent cause of dementia with vascular dementia (VaD) being second alongside with mixed AD and VaD, according to some. For some time, it has been proposed that cardiovascular disease (CaVD), hypertension, and diabetes mellitus (DM), which are known risk factors for VaD, also are associated with and contribute to the development of AD. Objective: The aim of this study was to investigate the prevalence of these proposed general risk factors, and to document presence of CaVD as evidenced from clinical records or from autopsy findings, further to correlate these with the diagnoses AD, VaD and mixed AD-VaD (MD), respectively. Methods: Autopsy reports at the Clinical Department of Pathology... (More)

Background: Alzheimer's disease (AD) is the most prevalent cause of dementia with vascular dementia (VaD) being second alongside with mixed AD and VaD, according to some. For some time, it has been proposed that cardiovascular disease (CaVD), hypertension, and diabetes mellitus (DM), which are known risk factors for VaD, also are associated with and contribute to the development of AD. Objective: The aim of this study was to investigate the prevalence of these proposed general risk factors, and to document presence of CaVD as evidenced from clinical records or from autopsy findings, further to correlate these with the diagnoses AD, VaD and mixed AD-VaD (MD), respectively. Methods: Autopsy reports at the Clinical Department of Pathology in Lund from 1992-2017 were analyzed. All cases with a complete autopsy report and a neuropathologically diagnosed dementia disorder (AD, VaD, or MD) were selected on the condition of a clinical diagnosis of dementia. Clinical data were retrieved through medical records and the Swedish National Diabetes Register (NDR). A total of 268 subjects were included. Results: In AD, there was less CaVD as significantly less organ/tissue findings (p < 0.05), significantly less hypertension (p < 0.001), and likewise significantly less DM (p = 0.0014) than in VaD, with the MD group results being set between these two in all aspects studied. Conclusion: AD and VaD exhibit such different profiles of organ and vascular damage as well as of hypertension and DM that they clearly point toward different pathogenic origin with low likelihood of shared risk factors.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Alzheimer's disease, autopsy, cardiovascular disease, dementia, dementia vascular, diabetes mellitus, hypertension, risk factors
in
Journal of Alzheimer's Disease
volume
65
issue
4
pages
12 pages
publisher
IOS Press
external identifiers
  • scopus:85054154157
ISSN
1387-2877
DOI
10.3233/JAD-180644
language
English
LU publication?
yes
id
93b0d83b-9929-4191-8c59-12d77d6cec5b
date added to LUP
2018-10-22 14:11:38
date last changed
2019-02-20 11:32:47
@article{93b0d83b-9929-4191-8c59-12d77d6cec5b,
  abstract     = {<p>Background: Alzheimer's disease (AD) is the most prevalent cause of dementia with vascular dementia (VaD) being second alongside with mixed AD and VaD, according to some. For some time, it has been proposed that cardiovascular disease (CaVD), hypertension, and diabetes mellitus (DM), which are known risk factors for VaD, also are associated with and contribute to the development of AD. Objective: The aim of this study was to investigate the prevalence of these proposed general risk factors, and to document presence of CaVD as evidenced from clinical records or from autopsy findings, further to correlate these with the diagnoses AD, VaD and mixed AD-VaD (MD), respectively. Methods: Autopsy reports at the Clinical Department of Pathology in Lund from 1992-2017 were analyzed. All cases with a complete autopsy report and a neuropathologically diagnosed dementia disorder (AD, VaD, or MD) were selected on the condition of a clinical diagnosis of dementia. Clinical data were retrieved through medical records and the Swedish National Diabetes Register (NDR). A total of 268 subjects were included. Results: In AD, there was less CaVD as significantly less organ/tissue findings (p &lt; 0.05), significantly less hypertension (p &lt; 0.001), and likewise significantly less DM (p = 0.0014) than in VaD, with the MD group results being set between these two in all aspects studied. Conclusion: AD and VaD exhibit such different profiles of organ and vascular damage as well as of hypertension and DM that they clearly point toward different pathogenic origin with low likelihood of shared risk factors.</p>},
  author       = {Javanshiri, Keivan and Waldö, Maria Landqvist and Friberg, Niklas and Sjövall, Fredrik and Wickerström, Karin and Haglund, Mattias and Englund, Elisabet},
  issn         = {1387-2877},
  keyword      = {Alzheimer's disease,autopsy,cardiovascular disease,dementia,dementia vascular,diabetes mellitus,hypertension,risk factors},
  language     = {eng},
  number       = {4},
  pages        = {1247--1258},
  publisher    = {IOS Press},
  series       = {Journal of Alzheimer's Disease},
  title        = {Atherosclerosis, Hypertension, and Diabetes in Alzheimer's Disease, Vascular Dementia, and Mixed Dementia : Prevalence and Presentation},
  url          = {http://dx.doi.org/10.3233/JAD-180644},
  volume       = {65},
  year         = {2018},
}