Cerebral Subcortical Small Vessel Disease in Subjects With Pathologically Confirmed Alzheimer Disease: A Clinicopathologic Study in the Oxford Project to Investigate Memory and Ageing (OPTIMA)
Abstract
The understanding of how cerebrovascular disease (CVD) contributes to dementia is hampered by a lack of agreed and validated pathologic methods to accord weight to the contribution of different aspects of CVD to dementia. A previous study from the Oxford Project to Investigate Memory and Ageing (OPTIMA) validated a scheme for assessing the contribution of subcortical small vessel disease (SVD) toward dementia in the elderly by showing a significant inverse relationship between the severity of SVD and cognition in subjects without any other dementia pathology using this method. In the present paper, the method has been used to assess severity of SVD in 161 cases of neuropathologically confirmed Alzheimer disease. The results showed there was no relationship between the SVD score and cognitive scores acquired in the last 2 years of life. SVD scores were significantly related to age (P<0.0017) and were slightly but significantly higher in females than males (P<0.049). SVD scores were not related to blood pressure at entry to OPTIMA and were significantly lower when compared with the cohort of OPTIMA cases with only CVD (mean 5.06 ± 1.85 vs. 5.9 ± 2.67; P<0.0065). We conclude that when Alzheimer disease pathology is present in elderly subjects, it overwhelms the modest contribution that SVD makes to cognitive impairment.
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CVD lowers the threshold for dementia in subjects with a pathological diagnosis of AD.
“neuropathological studies report that CVD lowers the threshold for dementia in subjects with a pathological diagnosis of AD [5],[6],[8],[9],[13],[17],[23],[51],[53],[81]-[83].”
From The overlap between vascular disease and Alzheimer’s disease - lessons from pathology (2014) · cites this paper as [8]
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- Authors
- Esiri, M. M., Joachim, C., Sloan, C., Christie, S., Agacinski, G., Bridges, L. R., Wilcock, G. K., & Smith, A. D.
- Affiliations
- St George's Hospital (GB)
- University of London (GB)
- University of Oxford (GB)
- Corresponding author
- Esiri, Margaret M.
- Joachim, Catharine
- Sloan, Carolyn
- Venue
- Alzheimer Disease & Associated Disorders
- Published
- 2014-01
- Volume
- 28
- Issue
- 1
- Pages
- 30-35
- ISSN
- 0893-0341 (ISSN-L)
- OpenAlex
- W2040818357
- Cited by
- 42
- References
- 35
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 2 · 2023: 5 · 2022: 2 · 2021: 4 · 2020: 2 · 2019: 2 · 2018: 7 · 2016: 1 · 2015: 3 · 2014: 9 · 2013: 1
- FWCI
- 3.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Alzheimer Disease & Associated Disorders (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Medical Research Council (MR/L022656/1)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
- Health Sciences › Medicine › Neurology › Cerebrovascular and genetic disorders
- Keywords
- Alzheimer's disease, cerebrovascular disease, dementia, cognitive impairment, neuropathology, sex differences, blood pressure, aging
- MeSH terms
- Aged, Aged, 80 and over, Aging, Alzheimer Disease, Brain, Cerebrovascular Disorders, Female, Humans, Male, Neuropsychological Tests
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