Cerebrovascular Disease (CeVD) Affects Alzheimer’s Severity

Researchers in Singapore have recommended that Alzheimer’s disease patients should be treated with as indicated by whether they have cerebrovascular disease. In an examination published in Brain, researchers in Singapore report that Alzheimer’s patients with and without co-occurring blood circulation problems in the brain may require different treatments.

The burden of dementia is increasing exponentially around the world, particularly in the Asia-Pacific, with an estimation that the number of dementia sufferers in the area will triple to 71 million individuals by 2050. In this same period, the number of dementia patients in Singapore is a common additionally projected to rise rapidly to 187,000.

Alzheimer’s disease is the most widely recognized type of dementia representing up to 60 percent of all cases. In addition, Alzheimer’s disease co-presenting cerebrovascular disease (CeVD), or blood circulation problems in the brain represents almost 20 percent of all dementia cases in Asia.

In this study, scientists at Singapore’s Duke-NUS Medical School (Duke-NUS) and the National University of Singapore Yong Loo Lin School of Medicine (NUS Medicine) analyzed a local cohort of 235 Singapore residents with prodromal (beginning period) and clinical Alzheimer’s disease.

They revealed that there are significant differences in functional connectivity and structural networks in the brains of patients with and without CeVD. In particular, only Alzheimer’s disease patients without CeVD exhibited decreased posterior default mode network functional connectivity, implying that their resting-state brain activity was abnormal.

Interestingly, patients with the double burden of Alzheimer’s disease and CeVD showed considerably more reduction of frontal executive control network functional network, which impairs their ability to execute thoughts and tasks.

These different presentations recommend that there may need to be different clinical approaches in treating patients who only have Alzheimer’s disease, and the individuals who either only have CeVD or have CeVD and also Alzheimer’s disease.

Study senior author Assistant Professor Juan Helen Zhou of Duke-NUS said, “In light of the growing prevalence of Alzheimer’s disease and CeVD in Asia, and particularly in Singapore, our discoveries could frame the reason for better patient management, disease monitoring, and long-term treatment planning”.

“Despite the fact that there is a growing awareness of Alzheimer’s disease and CeVD, the lack of well-defined criteria and treatment guidelines implies that Alzheimer’s disease with CeVD is largely underdiagnosed,” added the study’s co-author, Associate Professor Christopher Chen of NUS Medicine.

“With this study, we showed the combined impacts of Alzheimer’s disease and CeVD on brain network degeneration, and further examinations could reveal more insight into the clinical characteristics of these two important brain pathologies.”

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