Vascular Dementia and Alzheimer's Disease
Both vascular disease and Alzheimer's disease cause problems with thinking and memory and the death of brain tissue, although by different processes. However, as many as half of all brain autopsies conducted on people with AD reveal lesions characteristic of Alzheimer's disease as well as vascular lesions.
Researchers in many labs are still trying to understand the connection between the two conditions. There is, however, evidence already that both can exist independently in the same person. "Two injuries are worse than one," Dr. DeCarli said. "You're not going to do as well if you have both of those disease processes."
Using sophisticated MRI technology that provides highly accurate pictures of the shape and volume of brain structures, Dr. DeCarli is comparing the impact of the two disorders on the brain. He is focusing on the hippocampal formation, where very early indications of AD show themselves. If imaging shows that the hippocampus has shrunk, that suggests AD. If the effects of vascular disease are visible in other regions of the brain but the hippocampus looks normal, the person's thinking problems are more likely a result of vascular dementia. If Dr. DeCarli sees both, he reasons that both disease processes are occurring simultaneously.
As a researcher who also takes care of patients, Dr. DeCarli has treated people whom he suspects have both vascular dementia and Alzheimer's disease. Treatments exist for the vascular diseases that, when untreated, can lead to dementia, and Dr. DeCarli emphasizes they should be used when vascular disease is also present in a person with AD.
If a person with Alzheimer's disease also has hypertension, the doctor should treat it, he says. If she has diabetes, the doctor should treat the diabetes along with the Alzheimer's. And, Dr. DeCarli says, treating both diseases is likely to yield a better outcome than treating one.
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Excerpted from THE ALZHEIMER'S PROJECT: MOMENTUM IN SCIENCE, published by Public Affairs, www.publicaffairsbooks.com.
In This Section
- Vascular Disease
- Insulin Resistance and Diabetes
- Connecting Alzheimer's Disease to Vascular Disease
- Vascular Injury
- Vascular Dementia and Alzheimer's Disease
- The Problem of Cholesterol
- What's Good for the Heart is Good for the Brain
- Atherosclerosis and Alzheimer's Disease
- Associating Alzheimer's Disease with Insulin Resistance and Diabetes
- Diabetes and Insulin Resistance
- Insulin in the Brain
Momentum in Science: The Supplementary Series
- Understanding and Attacking Alzheimer's 12 min
- How Far We Have Come in Alzheimer's Research 15 min
- Identifying Mild Cognitive Impairment 20 min
- The Role of Genetics in Alzheimer's 12 min
- Advances in Brain Imaging 11 min
- Looking Into the Future of Alzheimer's 6 min
- The Connection Between Insulin and Alzheimer's 21 min
- Inflammation, the Immune System, and Alzheimer's 29 min
- The Benefit of Diet and Exercise in Alzheimer's 16 min
- Cognitive Reserve: What the Religious Orders Study is Revealing about Alzheimer's 20 min
- Searching for an Alzheimer's Cure: The Story of Flurizan 30 min
- The Pulse of Drug Development 15 min
- The DeMoe Family: Early-Onset Alzheimer's Genetics 25 min
- The Nanney/Felts Family: Late-Onset Alzheimer's Genetics 20 min
- The Quest for Biomarkers 17 min
Video: Inside the Brain: Unraveling the Mystery of Alzheimer's Disease
This 4-minute captioned video shows the progression of Alzheimer's disease in the brain.
Inside the Brain: An Interactive Tour
The Brain Tour explains how the brain works and how Alzheimer's affects it.
Alzheimer's Disease: Unraveling the Mystery
This book explains what AD is, describes the main areas in which researchers are working, and highlights new approaches for helping families and friends care for people with AD.
- About The Scientists
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- Rapid advances in our knowledge about AD have led to the development of promising new drugs and treatment strategies. However, before these new strategies can be used in clinical practice, they must be shown to work in people. Advances in prevention and treatment are only possible thanks to volunteers who participate in clinical trials.
- Among those touched by Alzheimer's (excluding self), nearly one-third provide support as a friend or relative, another 3% provide support as a healthcare professional, and the remaining two-thirds provide no support to the person suffering from Alzheimer's. When support is provided, it most often entails emotional support, followed by care-giving support. While small in comparison, more than one person in ten is providing financial support. Read more.