Carotid atherosclerosis promotes the progression of Alzheimer's disease: A three-year prospective study

Abstract

Although cerebrovascular diseases have been considered as risk factors for cognitive decline and dementia, the associations between atherosclerosis and Alzheimer's disease (AD) have not been fully examined and remain controversial. The aim of this three-year prospective study was to investigate whether arotid artery atherosclerosis accelerates cognitive impairment in AD patients. The association of carotid intimal medial thickness (IMT) with prospective trajectories of cognitive function was assessed among 521 patients with light to moderate AD, and 437 AD patients were followed up annually for 3 years. Participants underwent initial carotid ultrasonography and repeated neuropsychological testing every year. Mixed-effects regression analyses were adjusted to estimate the effect of carotid IMT and other adjusting variables. The results of the present study indicated that carotid IMT was significantly associated with various measures of cognitive function. Furthermore, AD patients with higher carotid IMT values had a faster decline in cognitive scores in a variety of neuropsychological tests, particularly in verbal and non-verbal memory, semantic fluency and executive function. The present prospective study showed that carotid atherosclerosis is a predictive factor regarding the progression of cognitive impairment in AD patients, suggesting that early detection and treatment of vascular risk factors may prevent or at least postpone the evolution of the disease.

Evaluation of hippocampal volume and serum brain-derived neurotrophic factor as potential diagnostic markers of conversion from amnestic mild cognitive impairment to Alzheimer disease

“…It has been previously reported that AD was closely correlated with vascular risk factors, and early detection and treatment of vascular risk factors may prevent or at least postpone the evolution of the disease. [26,27] Our study added evidences on the field of AD disease and indicated that AD represented a multifactorial disease where either genetic or acquired conditions interact. In future, it would be interesting to investigate whether this interaction is simply additive or even synergistic, and the mechanism underlying this interaction to influence the AD pathophysiology, to provide evidence to controlled AD.…”

Understanding and predicting the longitudinal course of dementia

“…The observation that comorbidity changed over time and had predictive value for institutionalization and mortality in the short but not in the long term, may support the suggested hypothesis of a dynamic relation between dementia progression and comorbidity [54]. As separate conditions, mainly cardiovascular comorbidities were tested and found to be related to dementia progression in including NPS [5 ▪▪ ,55,56]. However, other studies found no or only modest relations of vascular risk factors and vascular diseases with progression in Alzheimer's dementia [57] and LBD [58].…”

Comparisons of Daily Functional Performance and Relevant Factors in Patients with Alzheimer’s Disease and Subcortical Ischemic Vascular Disease

“…Several lines of evidence support the role of coexisting vascular pathologies in the cognitive function of elderly or demented patients. In a study of carotid ultrasonography, carotid atherosclerosis was a predictive factor for the progression of cognitive impairment in patients with AD [55]. In addition, apart from the occurrence of a clinical stroke, an epidemiology report highlighted associations between vascular risk factors including hypertension, diabetes mellitus, atrial fibrillation, and even silent infarct with the risk for subsequent dementia or cognitive decline [56].…”