Aggregate effects of vascular risk factors on cerebrovascular changes in autopsy‐confirmed Alzheimer's disease

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  • Katherine J. Bangen
    Department of Psychiatry University of California San Diego, La Jolla CA USA
  • Daniel A. Nation
    Veterans Affairs San Diego Healthcare System San Diego CA USA
  • Lisa Delano‐Wood
    Department of Psychiatry University of California San Diego, La Jolla CA USA
  • Gali H. Weissberger
    San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology San Diego CA USA
  • Lawrence A. Hansen
    Department of Neurosciences University of California San Diego, La Jolla CA USA
  • Douglas R. Galasko
    Veterans Affairs San Diego Healthcare System San Diego CA USA
  • David P. Salmon
    Department of Neurosciences University of California San Diego, La Jolla CA USA
  • Mark W. Bondi
    Department of Psychiatry University of California San Diego, La Jolla CA USA

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<jats:title>Abstract</jats:title><jats:sec><jats:label /><jats:p>We examined the relationships of antemortem vascular risk factors to postmortem cerebrovascular and Alzheimer's disease (AD) pathologies. Eighty‐four AD patients underwent an assessment of vascular risk (blood pressure, cholesterol, smoking, cardiovascular disease, diabetes, atrial fibrillation, transient ischemic attack [TIA], or stroke) and later underwent brain autopsy. Given our aim to examine mild cerebrovascular changes (CVCs), individuals were excluded if autopsy revealed large stroke. The most common forms of CVC were circle of Willis atherosclerosis followed by arteriosclerosis, lacunes, and microinfarcts. Excluding the history of TIA/clinical stroke, individual vascular risk factors were not associated with CVC. However, the presence of multiple vascular risk factors was associated with CVC. Furthermore, the presence of CVC was associated with lower Braak and Braak stage. These findings highlight the importance of aggregate risk in the vascular contribution to dementia. Interventions designed to maintain cerebrovascular health may represent important opportunities for preventing or delaying dementia, even when AD is the dominant pathology.</jats:p></jats:sec>

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