Tel-Aviv University Medical School, Tel-Aviv, Israel,
J Neural Transm (Vienna). 2013 Oct;120(10):1475-7. doi: 10.1007/s00702-013-1060-7. Epub 2013 Aug 11.
The epidemic proportions of dementia in old age are a cause of great concern for the medical profession and the society at large. It is customary to consider Alzheimer's disease (AD) as the most common cause of dementia, and vascular dementia (VaD) as being the second. This dichotomous view of a primary neurodegenerative disease as opposed to a disorder where extrinsic factors cause brain damage led to separate lines of research in these two entities. New biomarkers, particularly the introduction of modern neuroimaging and cerebrospinal fluid changes, have, in recent years, helped to identify anatomical and chemical changes of VaD and of AD. Nevertheless, there is a substantial difference between the two entities. While it is clear that VaD is a heterogeneous entity, AD is supposed to be a single disorder. Nobody attempts to use CADASIL as a template to develops treatment for sporadic VaD. On the other hand, early-onset AD is used to develop therapy for sporadic AD. This paper will discuss the problems relating to this false concept and its consequences.
老年痴呆症的流行程度是医学界和整个社会非常关注的问题。人们通常认为阿尔茨海默病（AD）是痴呆症最常见的原因，血管性痴呆（VaD）是第二常见的原因。这种将原发性神经退行性疾病与由外部因素引起的脑损伤区分开来的二分法观点导致了这两种疾病的研究方向分开。近年来，新的生物标志物，特别是现代神经影像学和脑脊液变化的引入，有助于识别 VaD 和 AD 的解剖和化学变化。然而，这两种疾病之间存在着很大的差异。虽然 VaD 显然是一种异质性疾病，但 AD 应该是一种单一的疾病。没有人试图用 CADASIL 作为模板来开发治疗散发性 VaD 的方法。另一方面，早发性 AD 则用于开发治疗散发性 AD 的方法。本文将讨论与这一错误概念及其后果相关的问题。
