Reduced clinical and postmortem measures of cardiac pathology in subjects with advanced Alzheimer's Disease.
BACKGROUND
Epidemiological studies indicate a statistical linkage between atherosclerotic vascular disease (ATH) and Alzheimer's disease (AD). Autopsy studies of cardiac disease in AD have been few and inconclusive. In this report, clinical and gross anatomic measures of cardiac disease were compared in deceased human subjects with and without AD.


METHODS
Clinically documented cardiovascular conditions from AD (n = 35) and elderly non-demented control subjects (n = 22) were obtained by review of medical records. Coronary artery stenosis and other gross anatomical measures, including heart weight, ventricular wall thickness, valvular circumferences, valvular calcifications and myocardial infarct number and volume were determined at autopsy.


RESULTS
Compared to non-demented age-similar control subjects, those with AD had significantly fewer total diagnosed clinical conditions (2.91 vs 4.18), decreased coronary artery stenosis (70.8 vs 74.8%), heart weight (402 vs 489 g for males; 319 vs 412 g for females) and valvular circumferences. Carriage of the Apolipoprotein E-ε4 allele did not influence the degree of coronary stenosis. Group differences in heart weight remained significant after adjustment for age, gender, body mass index and apolipoprotein E genotype while differences in coronary artery stenosis were significantly associated with body mass index alone.


CONCLUSIONS
The results are in agreement with an emerging understanding that, while midlife risk factors for ATH increase the risk for the later development of AD, once dementia begins, both risk factors and manifest disease diminish, possibly due to progressive weight loss with increasing dementia as well as disease involvement of the brain's vasomotor centers.
Banner Sun Health Research Institute, Sun City, AZ, USA. thomas.beach@bannerhealth.com
Thomas G
TG
Beach
Chera L
CL
Maarouf
Reed G
RG
Brooks
Scophil
S
Shirohi
Ian D
ID
Daugs
Lucia I
LI
Sue
Marwan N
MN
Sabbagh
Douglas G
DG
Walker
LihFen
L
Lue
Alex E
AE
Roher
D000544:Alzheimer Disease / Q000453:epidemiology*; D050197:Atherosclerosis / Q000453:epidemiology; D023921:Coronary Stenosis / Q000453:epidemiology* / Q000473:pathology; D003331:Coronary Vessels / Q000473:pathology; D005260:Female; D006351:Heart Valves / Q000473:pathology; D006352:Heart Ventricles / Q000473:pathology; D006801:Humans; D007091:Image Processing, Computer-Assisted; D016015:Logistic Models; D008297:Male; D009206:Myocardium / Q000473:pathology*; D009929:Organ Size; D015995:Prevalence
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