title: New cardiovascular targets to prevent late onset Alzheimer disease.
abstract: The prevalence of dementia rises to between 20% and 40% with advancing age. The dominant cause of dementia in approximately 70% of these patients is Alzheimer disease. There is no effective disease-modifying pharmaceutical treatment for this neurodegenerative disease. A wide range of Alzheimer drugs that appeared effective in animal models have recently failed to show clinical benefit in patients. However, hopeful news has emerged from recent studies that suggest that therapeutic strategies aimed at reducing cardiovascular disease may also reduce the prevalence of dementia due to Alzheimer disease. This review summarizes the evidence for this link between cardiovascular disease and late onset Alzheimer dementia. Only evidence from human research is considered here. Longitudinal studies show an association between high blood pressure and pathological accumulation of the protein amyloid-beta42, and an even stronger association between vascular stiffness and amyloid accumulation, in elderly subjects. Amyloid-beta42 accumulation is considered to be an early marker of Alzheimer disease, and increases the risk of subsequent cognitive decline and development of dementia. These observations could provide an explanation for recent observations of reduced dementia prevalence associated with improved cardiovascular care.
authors.affiliation: Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Radboud Alzheimer Center and Department of Geriatric Medicine, 925 Geriatric Medicine, PO Box 9101, 6500 HB Nijmegen, The Netherlands. Electronic address: jurgen.claassen@radboudumc.nl.
authors.forename: Jurgen A H R
authors.initials: JA
authors.lastname: Claassen
mesh_terms: D000544:Alzheimer Disease / Q000150:complications* / Q000517:prevention & control*; D000818:Animals; D002318:Cardiovascular Diseases / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism*; D006801:Humans; D058990:Molecular Targeted Therapy / Q000379:methods*
keywords: Cardiovascular disease; Cerebral blood flow; Cognitive impairment; Dementia