Rush Alzheimer's Disease Center, Rush University Medical Center, 1750 W Harrison Street, Suite 1000, Chicago, IL, 60612, USA.
Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, 1645 W Jackson Blvd, Suite 400, Chicago, IL, 60612, USA.
Neuropsychol Rev. 2020 Dec;30(4):546-557. doi: 10.1007/s11065-020-09460-6. Epub 2020 Oct 3.
Recent reports suggest declines in the age-specific risk of Alzheimer's dementia in higher income Western countries. At the same time, investigators believe that worldwide trends of increasing mid-life modifiable risk factors [e.g., cardiovascular disease (CVD) risk factors] coupled with the growth of the world's oldest age groups may nonetheless lead to an increase in Alzheimer's dementia. Thus, understanding the overlap in neuroanatomical profiles associated with CVD risk factors and AD may offer more relevant targets for investigating ways to reduce the growing dementia epidemic than current targets specific to isolated AD-related neuropathology. We hypothesized that a core group of common brain structural alterations exist between CVD risk factors and Alzheimer's dementia. Two co-authors conducted independent literature reviews in PubMed using search terms for CVD risk factor burden (separate searches for 'cardiovascular disease risk factors', 'hypertension', and 'Type 2 diabetes') and 'aging' or 'Alzheimer's dementia' with either 'grey matter volumes' or 'white matter'. Of studies that reported regionally localized results, we found support for our hypothesis, determining 23 regions commonly associated with both CVD risk factors and Alzheimer's dementia. Within this context, we outline future directions for research as well as larger cerebrovascular implications for these commonalities. Overall, this review supports previous as well as more recent calls for the consideration that both vascular and neurodegenerative factors contribute to the pathogenesis of dementia.
最近的报告表明，在高收入的西方国家，阿尔茨海默病痴呆的特定年龄风险有所下降。与此同时，研究人员认为，全球范围内中年可改变风险因素（例如心血管疾病（CVD）风险因素）的增加趋势，加上世界上最年长年龄组的增长，可能会导致阿尔茨海默病痴呆的增加。因此，了解与 CVD 风险因素和 AD 相关的神经解剖学特征的重叠可能为研究减少日益严重的痴呆症流行提供更相关的目标，而不是目前针对孤立的 AD 相关神经病理学的目标。我们假设 CVD 风险因素和阿尔茨海默病之间存在一组核心的常见大脑结构改变。两位合著者在 PubMed 中使用 CVD 风险因素负担的搜索词（分别搜索“心血管疾病风险因素”、“高血压”和“2 型糖尿病”）和“衰老”或“阿尔茨海默病”以及“灰质体积”或“白质”进行了独立的文献综述。对于报告区域性局部结果的研究，我们支持我们的假设，确定了 23 个与 CVD 风险因素和阿尔茨海默病都相关的常见区域。在这种情况下，我们概述了未来的研究方向以及这些共性对更大的脑血管的影响。总的来说，这项综述支持了以前以及最近的呼吁，即认为血管和神经退行性因素都有助于痴呆症的发病机制。
