Department of Clinical Sciences Lund, Division of Oncology and Pathology, Lund University, Sweden.
Department of Clinical Sciences Lund, Division of Clinical Sciences Helsingborg, Lund University, Sweden.
J Alzheimers Dis. 2018;65(4):1247-1258. doi: 10.3233/JAD-180644.
Alzheimer's disease (AD) is the most prevalent cause of dementia with vascular dementia (VaD) being second alongside with mixed AD and VaD, according to some. For some time, it has been proposed that cardiovascular disease (CaVD), hypertension, and diabetes mellitus (DM), which are known risk factors for VaD, also are associated with and contribute to the development of AD.
The aim of this study was to investigate the prevalence of these proposed general risk factors, and to document presence of CaVD as evidenced from clinical records or from autopsy findings, further to correlate these with the diagnoses AD, VaD and mixed AD-VaD (MD), respectively.
Autopsy reports at the Clinical Department of Pathology in Lund from 1992-2017 were analyzed. All cases with a complete autopsy report and a neuropathologically diagnosed dementia disorder (AD, VaD, or MD) were selected on the condition of a clinical diagnosis of dementia. Clinical data were retrieved through medical records and the Swedish National Diabetes Register (NDR). A total of 268 subjects were included.
In AD, there was less CaVD as significantly less organ/tissue findings (p < 0.05), significantly less hypertension (p < 0.001), and likewise significantly less DM (p = 0.0014) than in VaD, with the MD group results being set between these two in all aspects studied.
AD and VaD exhibit such different profiles of organ and vascular damage as well as of hypertension and DM that they clearly point toward different pathogenic origin with low likelihood of shared risk factors.
阿尔茨海默病（AD）是痴呆症最常见的病因，根据一些研究，血管性痴呆（VaD）位居第二，其次是 AD 和 VaD 混合。有一段时间以来，人们一直认为心血管疾病（CaVD）、高血压和糖尿病（DM）这些 VaD 的已知危险因素，也与 AD 的发展有关，并促成 AD 的发展。
本研究旨在调查这些被提出的一般危险因素的流行情况，并记录临床记录或尸检结果中 CaVD 的存在，进一步将这些与 AD、VaD 和 AD-VaD 混合（MD）的诊断分别相关联。
分析了来自 1992 年至 2017 年隆德临床病理学系的尸检报告。所有符合完全尸检报告和神经病理学诊断为痴呆症（AD、VaD 或 MD）的病例均在有痴呆临床诊断的条件下进行选择。临床数据通过病历和瑞典国家糖尿病登记处（NDR）检索。共纳入 268 例受试者。
在 AD 中，CaVD 明显较少，器官/组织发现明显较少（p < 0.05），高血压明显较少（p < 0.001），DM 也明显较少（p = 0.0014），而 MD 组的结果在各方面都介于这两者之间。
AD 和 VaD 表现出如此不同的器官和血管损伤以及高血压和 DM 特征，这清楚地表明它们具有不同的发病机制起源，且不太可能有共同的危险因素。
