Vascular diseases and old age mental disorders: an update of neuroimaging findings.
OBJECTIVE
To review neuroimaging findings that have been reported in samples of patients with cardiovascular disorders and their association with the onset of Alzheimer's disease, vascular dementia, depression and bipolar disorder in the elderly and to highlight the implications of these findings to the knowledge about the pathophysiology of psychiatric disorders in old age, as well as their potential clinical implications.


RESULTS
Vascular risk factors, such as hypertension, diabetes, dyslipidemia, smoking habits and heart failure, have all been associated with signs of cerebrovascular dysfunction, including structural MRI findings of signal hyperintensities, lacunes and stroke and functional imaging findings of brain regional hypoperfusion and hypometabolism. Such brain abnormalities have been found to increase the risk of onset of psychiatric disorder (depression, bipolar and dementia) in old age.


CONCLUSIONS
As vascular risk factors are potentially modifiable when detected in midlife, the early characterization of brain changes associated with the presence of cardiovascular diseases holds promise to afford clinical applications in psychiatry, providing new perspectives for the prevention of old age psychiatric disorders.
de Toledo Ferraz Alves
Tânia C
TC
Department of Psychiatry, University of São Paulo Medical School, Sao Paulo, Brazil. tania_alves@hotmail.com
Ferreira
Luiz K
LK
Busatto
Geraldo F
GF
D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging* / Q000473:pathology; D002318:Cardiovascular Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D056784:Leukoencephalopathies / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D001523:Mental Disorders / Q000150:complications / Q000000981:diagnostic imaging* / Q000473:pathology; D019964:Mood Disorders / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology; D011859:Radiography