Mahmoud Reza Azarpazhooh1, Abolfazl Avan2, Lauren E Cipriano3, David G Munoz4, Luciano A Sposato5, Vladimir Hachinski6. 1. Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada; Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada. 2. Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; Department of Neurology, Academic Medical Center, Amsterdam, The Netherlands. 3. Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Ivey Business School, Western University, London, Ontario, Canada. 4. Department of Pathology and Laboratory Medicine, University of Toronto & Department of Laboratory Medicine, and Keenan Research Centre for Biomedical Research, The Li Ka Shing Knowledge Institute, St Michael's Hospital Toronto, Ontario, Canada. 5. Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada; Stroke, Dementia and Heart Disease Laboratory, Western University, London, Ontario, Canada; Department of Anatomy & Cell Biology, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada. 6. Department of Clinical Neurological Sciences, Western University, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada. Electronic address: Vladimir.Hachinski@lhsc.on.ca.
Abstract
INTRODUCTION: The relative contributions of vascular and degenerative pathology to dementia are unknown. We aim to quantify the proportion of dementia explained by potentially preventable vascular lesions. METHODS: We systematically searched for population-based cohorts before February 2017 reporting clinicopathological data for individuals with and without dementia. We calculated the summary proportion and absolute risk of dementia comparing subjects with and without the pathology. RESULTS: We identified 10 studies comprising 2856 subjects. Vascular-type pathology and mixed pathology are respectively two and three times more likely in demented patients. The summary proportion of dementia is 77%-86% in subjects with mixed degenerative and vascular pathology and 45% in subjects with pure Alzheimer-type pathology. DISCUSSION: Patients with mixed pathologies have nearly twice the incremental risk of dementia compared with patients with only Alzheimer-type lesions. Consequently, many cases of dementia could be prevented or delayed by targeting the vascular component.
INTRODUCTION: The relative contributions of vascular and degenerative pathology to dementia are unknown. We aim to quantify the proportion of dementia explained by potentially preventable vascular lesions. METHODS: We systematically searched for population-based cohorts before February 2017 reporting clinicopathological data for individuals with and without dementia. We calculated the summary proportion and absolute risk of dementia comparing subjects with and without the pathology. RESULTS: We identified 10 studies comprising 2856 subjects. Vascular-type pathology and mixed pathology are respectively two and three times more likely in demented patients. The summary proportion of dementia is 77%-86% in subjects with mixed degenerative and vascular pathology and 45% in subjects with pure Alzheimer-type pathology. DISCUSSION: Patients with mixed pathologies have nearly twice the incremental risk of dementia compared with patients with only Alzheimer-type lesions. Consequently, many cases of dementia could be prevented or delayed by targeting the vascular component.
Authors: Vladimir Hachinski; Karl Einhäupl; Detlev Ganten; Suvarna Alladi; Carol Brayne; Blossom C M Stephan; Melanie D Sweeney; Berislav Zlokovic; Yasser Iturria-Medina; Costantino Iadecola; Nozomi Nishimura; Chris B Schaffer; Shawn N Whitehead; Sandra E Black; Leif Østergaard; Joanna Wardlaw; Steven Greenberg; Leif Friberg; Bo Norrving; Brian Rowe; Yves Joanette; Werner Hacke; Lewis Kuller; Martin Dichgans; Matthias Endres; Zaven S Khachaturian Journal: Alzheimers Dement Date: 2019-07 Impact factor: 21.566
Authors: Jennifer S Rabin; Hyun-Sik Yang; Aaron P Schultz; Bernard J Hanseeuw; Trey Hedden; Anand Viswanathan; Jennifer R Gatchel; Gad A Marshall; Emily Kilpatrick; Hannah Klein; Vaishnavi Rao; Rachel F Buckley; Wai-Ying Wendy Yau; Dylan R Kirn; Dorene M Rentz; Keith A Johnson; Reisa A Sperling; Jasmeer P Chhatwal Journal: Ann Neurol Date: 2019-01-07 Impact factor: 10.422
Authors: M S Bobola; L Chen; C K Ezeokeke; T A Olmstead; C Nguyen; A Sahota; R G Williams; P D Mourad Journal: Brain Stimul Date: 2020-04-01 Impact factor: 8.955
Authors: Jeremy A Elman; Matthew S Panizzon; Mark W Logue; Nathan A Gillespie; Michael C Neale; Chandra A Reynolds; Daniel E Gustavson; Brinda K Rana; Ole A Andreassen; Anders M Dale; Carol E Franz; Michael J Lyons; William S Kremen Journal: Neurobiol Aging Date: 2019-06-08 Impact factor: 4.673
Authors: David A Bennett; Aron S Buchman; Patricia A Boyle; Lisa L Barnes; Robert S Wilson; Julie A Schneider Journal: J Alzheimers Dis Date: 2018 Impact factor: 4.472