title: Clinical effect of cerebrovascular atherosclerosis on cognition in Alzheimer's disease.
abstract: BACKGROUND
  The association between cerebrovascular atherosclerosis and Alzheimer's disease (AD) has been examined in many cross-sectional studies; however, there are few data regarding the role of cerebrovascular atherosclerosis on the longitudinal course of cognitive decline in AD. The aim of this study was to examine the progression of cognitive function in AD patients with cerebrovascular atherosclerosis compared to those without atherosclerosis over a two-year period.
  
  
  METHODS
  Forty-seven AD patients with cerebrovascular atherosclerosis and 81 AD patients without atherosclerosis were assessed for cognitive function at the time of diagnosis and again at follow-up after two years. The cognitive functions were evaluated by neuropsychological tests including mini-mental state examination (MMSE) and clinical dementia scale (CDR).
  
  
  RESULTS
  Repeated-measures multivariate analyses showed that there was a significant group-by-time interactions for the temporal changes of the MMSE and CDR between the two groups. The group-by-time interactions remained significant when the atherosclerotic patients were sub-classified into either an extracranial stenosis (EC) group or an intracranial stenosis(IC) group. Comparing either the EC or IC group with the non-atherosclerosis group, there were no main effects by time or group alone, but there were significant group-by-time interactions for the MMSE and CDR.
  
  
  CONCLUSIONS
  Cognitive function worsened more in terms of progressive impairment in AD patients with cerebrovascular atherosclerosis compared to AD patients without cerebrovascular atherosclerosis, regardless of whether the atherosclerosis was extracranial or intracranial.
authors.affiliation: Department of Neurology, College of Medicine, The Catholic University of Korea, South Korea.
authors.forename: Tae-Won
authors.initials: TW
authors.lastname: Kim
authors.affiliation: Department of Neurology, College of Medicine, The Catholic University of Korea, South Korea. Electronic address: siuy@cmcnu.or.kr.
authors.forename: In-Uk
authors.initials: IU
authors.lastname: Song
authors.affiliation: Department of Neurology, College of Medicine, Soonchunhyang University, South Korea.
authors.forename: Du-Shin
authors.initials: DS
authors.lastname: Jeong
authors.affiliation: Department of Neurology, College of Medicine, The Catholic University of Korea, South Korea.
authors.forename: Kwang-Soo
authors.initials: KS
authors.lastname: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications* / Q000503:physiopathology / Q000523:psychology; D050197:Atherosclerosis / Q000150:complications* / Q000503:physiopathology; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D003704:Dementia / Q000175:diagnosis; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009483:Neuropsychological Tests
keywords: Alzheimer’s disease; Cognitive function; Extracranial stenosis; Intracranial stenosis