Cerebrovascular Disease Affects Noncognitive Symptoms in Alzheimer Disease

Vascular Dementia

“…These data, which varied from others that suggested a contribution to cognitive impairment in AD of CVLs even with volumes as low as 1 mL (256,280), were largely confirmed in a personal autopsy series (see Table 9). These data suggest that coexistent small CVLs with a total volume of less than 10 mL do not significantly influence the overall rate of progression of cognitive impairment in patients with AD; although a concomitant pathology can modulate both cognitive and noncognitive features (282). In AD with minor CVD, the majority of lesions were lacunes in the basal ganglia and multiple microinfarcts, whereas in MD, large lobar infarcts were more frequent than small CVLs (see Table 10), suggesting different pathogenic mechanisms.…”

Vascular Dementia

“…These data, which varied from others that suggested a contribution to cognitive impairment in AD of CVLs even with volumes as low as 1 mL (256,280), were largely confirmed in a personal autopsy series (see Table 9). These data suggest that coexistent small CVLs with a total volume of less than 10 mL do not significantly influence the overall rate of progression of cognitive impairment in patients with AD; although a concomitant pathology can modulate both cognitive and noncognitive features (282). In AD with minor CVD, the majority of lesions were lacunes in the basal ganglia and multiple microinfarcts, whereas in MD, large lobar infarcts were more frequent than small CVLs (see Table 10), suggesting different pathogenic mechanisms.…”

Understanding the pathology of vascular cognitive impairment

“…In AD with minor CVLs, the majority of lesions were lacunes in basal ganglia and/or white matter and multiple microinfarcts (Table 4), while in MD large lobar infarcts or multiple lesions were much more frequent (Table 5), suggesting different pathogenic mechanisms between both types of disorders. These data also suggest that coexistent small CVLs with a volume of less than 10 ml do not significantly influence the overall rate and progression of cognitive impairment in AD, although any concomitant pathology may influence both cognitive and non-cognitive features [52,57]. Elderly patients with subclinical or mild AD and little functional brain reserve (with frequent entorhinal tangles and moderate numbers of neuritic cortical plaques) who have critically located small CVLs, may demonstrate symptoms of intellectual decline, while in progressed or full-blown stage of AD with additional small CVLs that are frequently observed by modern neuroimaging methods, cognitive decline is mainly related to the severity and extent of AD pathology [12].…”

Épidémiologie de la maladie d’Alzheimer et des syndromes apparentés

“…Chez les sujets âgés, les lésions dues à la maladie d'Alzheimer sont rarement isolées, des lésions vasculaires étant associées de façon significative chez au moins un tiers des patients [70][71][72]. Chez les patients atteints de maladie d'Alzheimer avérée, si la pré-sence de petites lésions vasculaires ne semble pas influencer le déclin cognitif [73][74][75], elle est associée à des troubles moteurs (de type parkinsonien) et de la marche [76,77], des symptômes psychologiques et comportementaux (dont des symptômes dépressifs) [78], et une dysautonomie cardiovasculaire (hypotension orthostatique, hypersensibilité vagale) [79].…”

Vascular Dementia

“…These data, which varied from others that suggested a contribution to cognitive impairment in AD of CVLs even with volumes as low as 1 mL (256,280), were largely confirmed in a personal autopsy series (see Table 9). These data suggest that coexistent small CVLs with a total volume of less than 10 mL do not significantly influence the overall rate of progression of cognitive impairment in patients with AD; although a concomitant pathology can modulate both cognitive and noncognitive features (282). In AD with minor CVD, the majority of lesions were lacunes in the basal ganglia and multiple microinfarcts, whereas in MD, large lobar infarcts were more frequent than small CVLs (see Table 10), suggesting different pathogenic mechanisms.…”

Understanding the pathology of vascular cognitive impairment

“…In AD with minor CVLs, the majority of lesions were lacunes in basal ganglia and/or white matter and multiple microinfarcts (Table 4), while in MD large lobar infarcts or multiple lesions were much more frequent (Table 5), suggesting different pathogenic mechanisms between both types of disorders. These data also suggest that coexistent small CVLs with a volume of less than 10 ml do not significantly influence the overall rate and progression of cognitive impairment in AD, although any concomitant pathology may influence both cognitive and non-cognitive features [52,57]. Elderly patients with subclinical or mild AD and little functional brain reserve (with frequent entorhinal tangles and moderate numbers of neuritic cortical plaques) who have critically located small CVLs, may demonstrate symptoms of intellectual decline, while in progressed or full-blown stage of AD with additional small CVLs that are frequently observed by modern neuroimaging methods, cognitive decline is mainly related to the severity and extent of AD pathology [12].…”

Épidémiologie de la maladie d’Alzheimer et des syndromes apparentés

“…Chez les sujets âgés, les lésions dues à la maladie d'Alzheimer sont rarement isolées, des lésions vasculaires étant associées de façon significative chez au moins un tiers des patients [70][71][72]. Chez les patients atteints de maladie d'Alzheimer avérée, si la pré-sence de petites lésions vasculaires ne semble pas influencer le déclin cognitif [73][74][75], elle est associée à des troubles moteurs (de type parkinsonien) et de la marche [76,77], des symptômes psychologiques et comportementaux (dont des symptômes dépressifs) [78], et une dysautonomie cardiovasculaire (hypotension orthostatique, hypersensibilité vagale) [79].…”

Vascular Dementia

“…These data, which varied from others that suggested a contribution to cognitive impairment in AD of CVLs even with volumes as low as 1 mL (256,280), were largely confirmed in a personal autopsy series (see Table 9). These data suggest that coexistent small CVLs with a total volume of less than 10 mL do not significantly influence the overall rate of progression of cognitive impairment in patients with AD; although a concomitant pathology can modulate both cognitive and noncognitive features (282). In AD with minor CVD, the majority of lesions were lacunes in the basal ganglia and multiple microinfarcts, whereas in MD, large lobar infarcts were more frequent than small CVLs (see Table 10), suggesting different pathogenic mechanisms.…”

Understanding the pathology of vascular cognitive impairment

“…In AD with minor CVLs, the majority of lesions were lacunes in basal ganglia and/or white matter and multiple microinfarcts (Table 4), while in MD large lobar infarcts or multiple lesions were much more frequent (Table 5), suggesting different pathogenic mechanisms between both types of disorders. These data also suggest that coexistent small CVLs with a volume of less than 10 ml do not significantly influence the overall rate and progression of cognitive impairment in AD, although any concomitant pathology may influence both cognitive and non-cognitive features [52,57]. Elderly patients with subclinical or mild AD and little functional brain reserve (with frequent entorhinal tangles and moderate numbers of neuritic cortical plaques) who have critically located small CVLs, may demonstrate symptoms of intellectual decline, while in progressed or full-blown stage of AD with additional small CVLs that are frequently observed by modern neuroimaging methods, cognitive decline is mainly related to the severity and extent of AD pathology [12].…”

Épidémiologie de la maladie d’Alzheimer et des syndromes apparentés

“…Chez les sujets âgés, les lésions dues à la maladie d'Alzheimer sont rarement isolées, des lésions vasculaires étant associées de façon significative chez au moins un tiers des patients [70][71][72]. Chez les patients atteints de maladie d'Alzheimer avérée, si la pré-sence de petites lésions vasculaires ne semble pas influencer le déclin cognitif [73][74][75], elle est associée à des troubles moteurs (de type parkinsonien) et de la marche [76,77], des symptômes psychologiques et comportementaux (dont des symptômes dépressifs) [78], et une dysautonomie cardiovasculaire (hypotension orthostatique, hypersensibilité vagale) [79].…”