Alzheimer's disease is a vasocognopathy: a new term to describe its nature.
Considerable evidence now indicates that Alzheimer's disease (AD) is a vascular disorder with neurodegenerative consequences. As a result, AD and vascular dementia (VaD) can each be described as a 'vasocognopathy'. The term better describes the origin of the disease (vaso: vessel/blood flow), its primary effect on a system (-cogno: relating to cognition) and its clinical course (-pathy: disorder). Evidence that AD is a vasocognopathy is partly supported by the following multidisciplinary findings: (1) epidemiologic studies linking AD and vascular risk factors to cerebral hypoperfusion; (2) evidence that AD and vascular dementia (VaD) share practically all reported risk factors; (3) evidence that pharmacotherapy which increases or improves cerebral perfusion lowers AD symptoms; (4) evidence of preclinical detection of AD candidates using regional cerebral perfusion and glucose uptake studies; (5) evidence of overlapping clinical symptoms in AD and VaD; (6) evidence of parallel cerebrovascular and neurodegenerative pathologic markers (including plaques and tangles) in AD and VaD; (7) evidence that cerebral infarction increases AD incidence by 50%; (8) evidence that chronic brain hypoperfusion can trigger hypometabolic, cognitive and neurodegenerative changes typical of AD; (9) evidence that most autopsied AD brains contain cerebrovascular pathology; (10) evidence that mild cognitive impairment (a transition stage for AD) converts to AD or VaD in 48% and 56% of cases, respectively, within several years. The collective evidence presented here poses a powerful argument for the re-classification of AD as a vascular disorder. Re-classification would allow a new strategy that could result in the tactical development and application of genuinely effective treatments, provide earlier diagnosis and reduce AD prevalence by focusing on the root of the problem.
de la Torre
Jack C
JC
Institute of Pathology, Case Western Reserve University, Cleveland, OH, USA. jcdelatorre@cox.net
D000544:Alzheimer Disease / Q000145:classification / Q000209:etiology* / Q000473:pathology*; D015984:Causality; D002536:Cerebral Arteries / Q000473:pathology* / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000187:drug effects / Q000502:physiology; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000188:drug therapy / Q000473:pathology*; D015140:Dementia, Vascular / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007022:Hypotension / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D009626:Terminology as Topic; D014665:Vasodilator Agents / Q000494:pharmacology / Q000627:therapeutic use
D014665:Vasodilator Agents