Genetic and Vascular Risk Factors for Cognitive Decline and Cerebral Small-Vessel Disease
Year: 2006
Type: dissertation
Abstract: One of the earliest known written reports on dementia is attributed to Pythagoras in the 7th\ncentury BC, who described old age as a period of decline and decay of the human body and\nregression of mental capacities. In 1907, Alois Alzheimer, a german psychiatrist and scientist,\nobserved at necropsy an overload of - at that time still unknown - amyloid plaques and\nneurofi brillary tangles in the brain of a 51 year old woman who had suff ered during her life\ncourse from progressive cognitive decline. Nowadays, amyloid plaques and neurofi brillary\ntangles are considered the main neuropathological hallmarks of Alzheimer’s disease, which is\nregarded the most frequent subtype of dementia.\nOver the past two decades evidence has been accumulating that dementia is a heterogeneous\nand multifactorial disorder, and that besides accumulation of beta amyloid and neurofi brillary\ntangles, other factors, in particular vascular risk factors and cerebrovascular disease, may\nbe involved, especially in late-onset dementia. Observational studies reported associations\nbetween several vascular risk factors and cognitive decline and dementia. In autopsy studies,\nabout 35% of the brains of elderly persons, who had been diagnosed with dementia during\ntheir lifetime, had not only a higher burden of amyloid plaques and neurofi brillar tangles but\nrather a mixed pathology also consisting of signifi cant cerebrovascular disease. Stroke has\nbeen reported to considerably increase the risk of dementia, with prevalence rates of poststroke\ndementia of about 30%, refl ecting a 3.6 to 5.8-fold increased risk of dementia compared\nto stroke-free subjects. Cerebral small-vessel disease, which is defi ned as cerebral white matter\nlesions and asymptomatic lacunar brain infarcts and is a common fi nding on brain scans of\nelderly persons, has been reported to more than double the risk of dementia.
Author: Christiane Reitz
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2152777071