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Vascular cognitive impairment and Alzheimer's disease: Is there a relationship between them?

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Cognitive impairment (CI) associated with brain aging is a consequence of disorders varying in etiology and pathogenesis, which often coexist in elderly patients and can have a mutual impact on the clinical manifestation, severity, and rate of progression of CI. Alzheimer's disease (AD) and vascular CI are the most common forms of dementia in the elderly. In recent decades, there has been increasing evidence that there is a close relationship between these forms due to a substantial overlap of their risk factors, clinical manifestations, neuromorphological changes, as well as genetic and neuroimaging biomarkers. The complex multicomponent relationship of these disorders also makes it difficult to elaborate effective preventive and therapeutic approaches in these patients.

About the Authors

G. R. Tabeeva
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

Department of Nervous System Diseases and Neurosurgery,

11, Rossolimo St., Build. 1, Moscow 119021

E. A. Kirjanova
I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
Russian Federation

Department of Nervous System Diseases and Neurosurgery,

11, Rossolimo St., Build. 1, Moscow 119021


1. Oeppen J, Vaupel JW. Broken limits to life expectancy. Science. 2002 May 10;296(5570):1029-31.

2. Hebert LE, Weuve J, Scherr PA, Evans DA. Alzheimer disease in the United States (2010- 2050) estimated using the 2010 census. Neurology. 2013 May 7;80(19):1778-83. doi: 10.1212/WNL.0b013e31828726f5. Epub 2013 Feb 6.

3. van Norden AGW, van Dijk EJ, de Laat KF, et al. Dementia: Alzheimer pathology and vascular factors: From mutually exclusive to interaction. Biochim Biophys Acta. 2012 Mar;1822(3): 340-9. doi: 10.1016/j.bbadis.2011.07.003. Epub 2011 Jul 14.

4. Ungvari Z, Kaley G, de Cabo R, et al. Mechanisms of vascular aging: new perspectives. J Gerontol A Biol Sci Med Sci. 2010 Oct; 65(10):1028-41. doi: 10.1093/gerona/glq113. Epub 2010 Jun 24.

5. Snyder HM, Corriveau RA, Craft S, et al. Vascular contributions to cognitive impairment and dementia including Alzheimer's disease. Alzheimers Dement. 2015 Jun;11(6):710-7. doi: 10.1016/j.jalz.2014.10.008. Epub 2014 Dec 12.

6. Toth P, Tucsek Z, Sosnowska D, et al. Agerelated autoregulatory dysfunction and cerebromicrovascular injury in mice with angiotensin II- induced hypertension. J Cereb Blood Flow Metab. 2013 Nov;33(11):1732-42. doi: 10.1038/jcbfm.2013.143. Epub 2013 Aug 14.

7. Deak F, Freeman WM, Ungvari Z, et al. Recent Developments in Understanding Brain Aging: Implications for Alzheimer's Disease and Vascular Cognitive Impairment. J Gerontol A Biol Sci Med Sci. 2016 Jan;71(1):13-20. doi: 10.1093/gerona/glv206. Epub 2015 Nov 20.

8. Sorond FA, Kiely DK, Galica A, et al. Neurovascular coupling is impaired in slow walkers: the MOBILIZE Boston Study. Ann Neurol. 2011 Aug;70(2):213-20. doi: 10.1002/ana.22433. Epub 2011 Jun 14.

9. Kress BT, Iliff JJ, Xia M, et al. Impairment of paravascular clearance pathways in the aging brain. Ann Neurol. 2014 Dec;76(6):845-61. doi: 10.1002/ana.24271. Epub 2014 Sep 26.

10. Vinters HV. Emerging concepts in Alzheimer's disease. Annu Rev Pathol. 2015;10: 291-319. doi: 10.1146/annurev-pathol-020712-163927. Epub 2014 Oct 29.

11. Jefferson AL, Hohman TJ, Liu D, et al. Adverse vascular risk is related to cognitive decline in older adults. J Alzheimers Dis. 2015; 44(4):1361-73. doi: 10.3233/JAD-141812.

12. Viticchi G, Falsetti L, Buratti L, et al. Framingham risk score can predict cognitive decline progression in Alzheimer's disease. Neurobiol Aging. 2015 Nov;36(11):2940-2945. doi: 10.1016/j.neurobiolaging.2015.07.023. Epub 2015 Jul 26.

13. Ostroumova TM, Parfenov VV, Ostroumova OD. Hypertension and cognitive impairment: the standpoint of evidence-based medicine. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2017;9(4):70-6. (In Russ.). doi: 10.14412/2074-2711-2017-4-70-76

14. Power MC, Weuve J, Gagne JJ, et al. The association between blood pressure and incident Alzheimer disease: a systematic review and meta-analysis. Epidemiology. 2011 Sep;22(5): 646-59. doi: 10.1097/EDE.0b013e31822708b5.

15. Xu G, Bai F, Lin X, et al. Association between Antihypertensive Drug Use and the Incidence of Cognitive Decline and Dementia: A Meta-Analysis of Prospective Cohort Studies. Biomed Res Int. 2017;2017:4368474. doi: 10.1155/2017/4368474. Epub 2017 Sep 28.

16. Verghese J, Lipton RB, Katz MJ, et al. Leisure Activities and the Risk of Dementia in the Elderly. N Engl J Med. 2003 Jun 19; 348(25):2508-16.

17. Ruitenberg A, Skoog I, Ott A, et al. Blood pressure and risk of dementia: results from the rotterdam study and the Gothenburg H-70 Study. Dement Geriatr Cogn Disord. 2001 JanFeb;12(1):33-9.

18. Kennelly SP, Lawlor BA, Kenny RA. Blood pressure and dementia - a comprehensive review. Ther Adv Neurol Disord. 2009 Jul;2(4):241-60. doi: 10.1177/1756285609103483.

19. Gregson J, Qizilbash N, Iwagami M, et al. Blood pressure and risk of dementia and its subtypes: a historical cohort study with long-term follow-up in 2.6 million people. Eur J Neurol. 2019 Jun 24. doi: 10.1111/ene.14030. [Epub ahead of print].

20. Santos CY, Snyder PJ, Wu WC, et al. Pathophysiologic relationship between Alzheimer's disease, cerebrovascular disease, and cardiovascular risk: A review and synthesis. Alzheimers Dement (Amst). 2017 Feb 9;7:69-87. doi: 10.1016/j.dadm.2017.01.005. eCollection 2017.

21. Li G, Larson EB, Sonnen JA, et al. Statin therapy is associated with reduced neuropathologic changes in Azlheimer's disease. Neurology. 2007 Aug 28;69(9):878-85.

22. Feldman HH, Doody RS, Kivipelto M, et al. Randomized controlled trial of atorvastatin in mild to moderate Alzheimer disease: LEADe. Neurology. 2010 Mar 23;74(12):956-64. doi: 10.1212/WNL.0b013e3181d6476a. Epub 2010 Mar 3.

23. Schilling MA. Unraveling Alzheimer's: Making Sense of the Relationship between Diabetes and Alzheimer's Disease. J Alzheimers Dis. 2016; 51(4):961-77. doi: 10.3233/JAD-150980.

24. Groot C, Hooghiemstra AM, Raijmakers PG, et al. The effect of physical activity on cognitive function in patients with dementia: A metaanalysis of randomized control trials. Ageing Res Rev. 2016 Jan;25:13-23. doi: 10.1016/j.arr.2015.11.005. Epub 2015 Nov 28.

25. Anstey KJ, von Sanden C, Salim A, O'Kearney R. Smoking as a risk factor for dementia and cognitive decline: a meta-analysis of prospective studies. Am J Epidemiol. 2007 Aug 15;166(4):367-78. Epub 2007 Jun 14.

26. Kalaria RN. Neuropathological diagnosis of vascular cognitive impairment and vascular dementia with implications for Alzheimer's disease. Acta Neuropathol. 2016 May;131(5):659-85. doi: 10.1007/s00401-016-1571-z. Epub 2016 Apr 9.

27. Schneider JA, Arvanitakis Z, Bang W, Bennett DA. Mixed brain pathologies account for most dementia cases in community-dwelling older persons. Neurology. 2007 Dec 11;69(24): 2197-204. Epub 2007 Jun 13.

28. Snowdon DA, Greiner LH, Mortimer JA, et al. Brain infarction and the clinical expression of Alzheimer disease. The Nun Study. JAMA. 1997 Mar 12;277(10):813-7.

29. Tabeeva GR. Mixed dementia: the role of cerebrovascular pathology. Zhurnal nevrologii i psikhiatrii im. S. S. Kosakova. 2018; (9):98-103. (In Russ.).

30. Iturria-Medina Y, Sotero RC, Toussaint PJ, et al; Alzheimer's Disease Neuroimaging Initiative. Early role of vascular dysregulation on late-onset Alzheimer's disease based on multifactorial data-driven analysis. Nat Commun. 2016 Jun 21;7:11934. doi: 10.1038/ncomms11934.

31. Bertram L, Lill CM, Tanzi RE. The genetics of Alzheimer disease: back to the future. Neuron. 2010 Oct 21;68(2):270-81. doi: 10.1016/j.neuron.2010.10.013.

32. Strickland S. Blood will out: vascular contributions to Alzheimer's disease. J Clin Invest. 2018 Feb 1;128(2):556-563. doi: 10.1172/JCI97509. Epub 2018 Feb 1.

33. Lindemer ER, Salat DH, Smith EE, et al. White matter signal abnormality quality differentiates mild cognitive impairment that converts to Alzheimer's disease from nonconverters. Neurobiol Aging. 2015 Sep;36(9):2447-57. doi: 10.1016/j.neurobiolaging.2015.05.011. Epub 2015 May 28.

34. Berman SE, Rivera-Rivera LA, Clark LR, et al. Intracranial arterial 4D-flow is associated with metrics of brain health and Alzheimer's disease. Alzheimers Dement (Amst). 2015 Dec 1; 1(4):420-428.

35. Kalaria RN, Akinyemi R, Ihara M. Does vascular pathology contribute to Alzheimer changes? J Neurol Sci. 2012 Nov 15;322(1-2): 141-7. doi: 10.1016/j.jns.2012.07.032. Epub 2012 Aug 11.

36. Hartz AM, Bauer B, Soldner EL, et al. Amyloid-beta contribuites to blood-brain barrier leakage in transgenic human amyloid precursor protein mice and in humans with cerebral amyloid angiopathy. Stroke. 2012 Feb;43(2): 514-23. doi: 10.1161/STROKEAHA.111.627562. Epub 2011 Nov 23.

37. Davies P, Maloney AJ. Selective loss of central cholinergic neurons in Alzheimer's disease. Lancet. 1976 Dec 25;2(8000):1403.

38. Zhang YS, Li JD, Yan C. An update on vinpocetine: New discoveries and clinical implications. Eur J Pharmacol. 2018 Jan 15;819: 30-34. doi: 10.1016/j.ejphar.2017.11.041. Epub 2017 Nov 26.

39. Afanas'ev VV, Rumyantseva SA. Mechanisms of action and clinical application of Cavinton. Klinicheskaya farmakologiya. 2010;(2):13-6. (In Russ.).

40. Bonoczk P, Gulyas B, Adam-Vizi V, et al. Role of sodium channel inhibition in neuroprotection: effect of vinpocetine. Brain Res Bull. 2000 Oct;53(3):245-54.

41. Cai Y, Knight WE, Guo S, et al. Vinpocetine suppresses pathological vascular remodeling by inhibiting vascular smooth muscle cell proliferation and migration. J Pharmacol Exp Ther. 2012 Nov;343(2):479-88. doi: 10.1124/jpet.112.195446. Epub 2012 Aug 22.

42. Zhang F, Yan C, Wei C, et al. Vinpocetine Inhibits NF-kappaB-Dependent Inflammation in Acute Ischemic Stroke Patients. Transl Stroke Res. 2018 Apr;9(2):174-184. doi: 10.1007/s12975-017-0549-z. Epub 2017 Jul 9.


For citations:

Tabeeva G.R., Kirjanova E.A. Vascular cognitive impairment and Alzheimer's disease: Is there a relationship between them? Neurology, Neuropsychiatry, Psychosomatics. 2019;11(3):110-115. (In Russ.)

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ISSN 2074-2711 (Print)
ISSN 2310-1342 (Online)