Severity of cardiovascular disease, apolipoprotein E genotype, and brain pathology in aging and dementia.

Neuropathological lesions, essential for the diagnosis of Alzheimer's disease (AD), such as senile-neuritic plaques (SP/NPs), neurofibrillary tangles (NFTs), the beta-amyloid load (A beta 4) and the load of PHF-tau did not increase with increased severity of cardiovascular disease in 126 clinically demented and 303 nondemented aged individuals. In contrast, the extent of AD lesions was greater in nondemented and demented individuals with the ApoE epsilon 4 allele compared to those without this allele. On the other hand, the extent of vascular lesions currently used for the diagnosis of vascular dementia (VaD) showed correlation with the cardiovascular index, whereas ApoE epsilon 4 allele did not seem to influence the extent of vascular lesions. The calculated CVI showed significant correlation with premortem estimated Hachinski score, and both the CVI and Hachinski score were higher in demented patients with extensive vascular lesions. Our results demonstrate that ApoE epsilon 4 allele, a known risk factor for dementia, indeed influences the extent of Alzheimer's lesions seen in the brain tissue of demented patients and asymptomatic controls. The cardiovascular disease again seems to influence the extent of vascular lesions.