Friday, October 19

Diagnosing Dementia: Alzheimer's May Really Be Mini-Strokes

Memory problems are too quickly diagnosed as Alzheimer's. (In Alzheimer's, the culprit is amyloid-plaque in the brain.) New research shows a more common memory-culprit may be vascular dementia, caused by stroke, mini-stroke and high blood pressure. Learn the difference and why the right diagnosis effects therapy and treatment.

Alzheimer's is connected to sticky plaques made of beta-amyloid that choke brain cells, thereby causing dementia. People may act like they have Alzheimer's when they really have vascular dementia. Vascular dementia is caused by vascular events (related to blood vessels) such as strokes and mini-strokes, so treatment is different. (Mini-strokes occur in the brain when blood vessels clog up or burst. They can accumulate slowly and can go unnoticed for years.)

For example, the damage caused by plaque is typically treated with acetylcholinesterase inhibitors like Aricept®. These drugs target the nervous system. Vascular problems like mini-strokes are treated with blood-targeting medications and therapies.

Alzheimer's disease and vascular dementia are two types of dementia that are common in the elderly. A person's dementia can even be caused by a combination of the two, called "Mixed Dementia."

With today's technology, both vascular brain injury as well as beta-amyloid plaque can be detected in the brain. They both cause memory and thinking problems, called "cognitive impairment". If the cognitive impairment is strong and interferes with a typical person's day, it is called dementia. If it is mild, it is called MCI (Mild Cognitive Impairment).

Until now, doctors generally assumed that when they saw cognitive impairment, it was probably from plaque building up in the brain. Treatment and therapy were given accordingly. New research is showing that vascular brain injury from strokes or the mini-strokes often caused by high blood pressure may deserve the greater part of their attention.

A study at the Alzheimer’s Disease Research Center at UC Davis has found that vascular brain injury from conditions such as high blood pressure and stroke are greater risk factors for cognitive impairment among non-demented older people than is the deposition of the amyloid plaques in the brain that long have been implicated in conditions such as Alzheimer’s disease.
Bruce Reed
Bruce Reed















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  1. I guess that this imporntant research article is a "turning point ' in AD research , and
    It research article can be considered as a milestone paper , tbat proved that one of the main starters of AD and others age-related dementias are the ageing-related macro and microvascular brain disorders.

    The article comproves again that the betamyloid acccumulation it is more for a "witness" (some times a toxic witness) than the culprit of dementias as AD.

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