Vascular changes in the brains with Alzheimer's disease.

Sections of temporal and occipital cortex from 14 patients with Alzheimer's disease were examined by light and electron microscopy. Especially, areas without senile plaques or neurofibrillary degeneration were examined in detail. The initial change in the cerebral cortex occurred in the capillaries. The endothelial cells demonstrated degeneration with hypertrophic distorted basement membranes and swelling of the vascular feet. Lipochromes were found in the processes and cell bodies of the astrocytes. A decrease in the number of nerve cells and their processes noted in the cortices may be due to primary vascular degeneration. Severe dementia in Alzheimer's disease may be related to the histopathological findings of diffusely destroyed nerve cells and their processes.