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The Cerebrovascular Pathology in Alzheimer's Disease and Its Influence on Clinical Variables

Department of Neurology, Hospital Universitario Miguel Servet, Zaragoza, pmodrego{at}salud.aragon.es

Consuelo Rios, MD

Neurology Unit, Hospital de Barbastro, Barbastro, Huesca

José M. Pérez Trullen, MD

Neurology Unit, Hospital Royo Villanova, Zaragoza

José M. Errea, MD

Neurology Unit, Hospital de Barbastro, Barbastro, Huesca

Maria J. García-Gómara, MD

Neurology Unit Hospital Ernest Lluch, Calatayud, Zaragoza, Spain

Sara Sanchez, MD

Neurology Unit Hospital Ernest Lluch, Calatayud, Zaragoza, Spain

Vascular pathology is frequently found in the brains of patients with Alzheimer's disease (AD). The aim of this study is to assess the frequency of vascular pathology in the brain in AD patients in a systematic manner and its clinical significance at presentation. A series of 51 patients with mild to moderate AD were consecutively enrolled. At baseline, every patient underwent the following clinical scales: Mini-Mental, Clinical Dementia Rating Scale, Ischemic Scale, Blessed Dementia Rating Scale, Alzheimer's Disease Assessment Scale Cognitive Subscale, Neuropsychiatric Inventory, and an Activities of Daily Living Scale (Disability Assessment for Dementia). We also carried out magnetic resonance imaging of the brain and color echo Doppler of carotids to measure the intima-media thickness. White matter hyperintensities were quantitatively evaluated with the Wahlund scale. We did not find correlation between intima-media thicknesses of carotids and clinical scales and between the Wahlund scale and clinical scales. The presence or absence of both microinfarctions and hypertension had no influence in the scores of the clinical scales. We conclude that the vascular component is common in AD but only as coincident pathology.

Key Words: vascular pathology • Alzheimer's disease • vascular dementia

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