Center for Alzheimer's Research, Banner Sun Health Research Institute, Sun City, AZ 85351, USA.
Neurodegener Dis. 2010;7(1-3):116-21. doi: 10.1159/000285520. Epub 2010 Feb 18.
The vascular hypothesis of Alzheimer's disease (AD) which we first proposed in 1993, has become a useful concept in identifying vascular risk factors for AD or vascular dementia that can be modified through appropriate treatment to prevent, reduce or delay the onset of cognitive impairment and dementia onset. Among the more than two dozen vascular risk factors already identified for AD, are cardiovascular disease and carotid artery atherosclerosis, which may exert their pathology by chronically lowering cerebral hypoperfusion during aging. We propose and plan to initiate a clinical study to screen middle-aged, cognitively intact individuals, with carotid artery ultrasound and echocardiography to identify potentially progressive pathology in the heart and carotid artery that is considered modifiable with optimal medical treatment. This clinical strategy, if found effective in preventing pathologic conditions suspected of contributing to severe cognitive impairment, could significantly reduce AD prevalence if applied on a wide scale and help promote healthier mental and physical aging while providing a compelling economic benefit to society.
我们在 1993 年首次提出阿尔茨海默病（AD）的血管假说，该假说已成为识别 AD 或血管性痴呆的血管风险因素的有用概念，这些风险因素可以通过适当的治疗加以改变，以预防、减少或延迟认知障碍和痴呆的发生。在已经确定的 20 多种 AD 血管风险因素中，包括心血管疾病和颈动脉动脉粥样硬化，它们可能通过在衰老过程中持续降低脑灌注来发挥其病理学作用。我们提出并计划启动一项临床研究，对认知功能正常的中年人群进行颈动脉超声和超声心动图检查，以识别心脏和颈动脉中可能进行性的病理变化，这些变化被认为可以通过最佳的药物治疗来改变。如果这种临床策略被发现能有效预防疑似导致严重认知障碍的病理状况，那么如果广泛应用，它将显著降低 AD 的发病率，有助于促进更健康的心理和身体衰老，并为社会带来巨大的经济效益。
