Korczyn Amos D, Vakhapova Veronika
The Sieratzki Chair of Neurology, Tel-Aviv University Medical School, Ramat Aviv 69978, Israel.
J Neurol Sci. 2007 Jun 15;257(1-2):2-4. doi: 10.1016/j.jns.2007.01.081. Epub 2007 May 8.
Alzheimer's disease (AD) is considered to be the most common dementing disorder. The understanding of this disorder has greatly advanced over the past few years, and new therapeutic options have been developed. Another disorder, vascular dementia (VaD), is a syndrome with multiple etiologies operating through a variety of different mechanisms. The combination of AD and VaD is extremely common, making mixed dementia the most common type of dementia. Risk factors for VaD, which are the common vascular risk factors, are presently known to apply also to AD. Cholinergic deficits occur in both conditions. The identification of several genetic factors that can contribute to vascular damage, as well as possible auto-immune damage to vascular components, are important. It is remarkable that amyloid precursor protein (APP) mutations can cause the typical pathological changes of AD as well as amyloid deposition around blood vessels. These may lead to deficient blood perfusion to the brain, changes of the blood-brain barrier, as well as cerebral hemorrhages. Interestingly, attention to risk factors, such as hypertension, coronary artery disease, hyperlipidemia and smoking could reduce or delay the incidence of dementia, both vascular and AD.
阿尔茨海默病（AD）被认为是最常见的痴呆症。在过去几年里，对这种疾病的认识有了很大进展，并且已经开发出了新的治疗方法。另一种疾病，血管性痴呆（VaD），是一种由多种病因通过多种不同机制起作用的综合征。AD和VaD的合并极为常见，使得混合性痴呆成为最常见的痴呆类型。目前已知VaD的危险因素，即常见的血管危险因素，也适用于AD。两种情况都会出现胆碱能缺陷。识别几种可能导致血管损伤的遗传因素以及对血管成分可能的自身免疫损伤很重要。值得注意的是，淀粉样前体蛋白（APP）突变可导致AD的典型病理变化以及血管周围的淀粉样沉积。这些可能导致大脑血液灌注不足、血脑屏障改变以及脑出血。有趣的是，关注高血压、冠状动脉疾病、高脂血症和吸烟等危险因素可以降低或延缓血管性痴呆和AD的发病率。
