Vascular risk factors and Alzheimer's disease.
Vascular risk factors and Alzheimer's disease.
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DOI：
10.1586/14737175.8.5.743
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发表时间：
2008-05-01
影响因子：
4.3
通讯作者：
Whitehead, Shawn N
中科院分区：
文献类型：
--
作者：
Cechetto, David F;Hachinski, Vladimir;Whitehead, Shawn N
血管性认知障碍的危险因素包括中风、高血压、糖尿病和动脉粥样硬化。在老年人中，血管危险因素发生在老年大脑中存在高水平淀粉样蛋白的情况下。中风改变了阿尔茨海默病（AD）病理学的给定负荷的临床表达。实验上，淀粉样蛋白存在时，大血管梗死或小纹状体梗死更大。轻度脑梗死和中度AD病变的患者将出现痴呆的临床表现。此外，其他血管危险因素与认知能力下降和痴呆的临床表现之间也存在相关性。患有成人型糖尿病、高血压、动脉粥样硬化性疾病和房颤的受试者中AD的风险增加。实验上，与单独的纹状体梗死或高淀粉样蛋白水平相比，在脑中存在高水平淀粉样蛋白的情况下，小的纹状体梗死表现出梗死面积随时间推移的进展，认知障碍、AD型病理学和神经炎症的程度增强。
Vascular cognitive impairment risk factors include stroke, hypertension, diabetes and atherosclerosis. In the elderly, vascular risk factors occur in the presence of high levels of amyloid in the aging brain. Stroke alters the clinical expression of a given load of Alzheimer's disease (AD) pathology. Experimentally, large vessel infarcts or small striatal infarcts are larger in the presence of amyloid. Patients with minor cerebral infarcts and moderate AD lesions will develop the clinical manifestations of dementia. Moreover, there is also an association between other vascular risk factors and the clinical expression of cognitive decline and dementia. The risk of AD is increased in subjects with adult-onset diabetes mellitus, hypertension, atherosclerotic disease and atrial fibrillation. Experimentally, small striatal infarcts in the presence of high levels of amyloid in the brain exhibit a progression in infarct size over time with enhanced degree of cognitive impairment, AD-type pathology and neuroinflammation compared with striatal infarcts or high amyloid levels alone.