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Concomitant vascular and neurodegenerative pathologies double the risk of dementia
Author(s) -
Azarpazhooh Mahmoud Reza,
Avan Abolfazl,
Cipriano Lauren E.,
Munoz David G.,
Sposato Luciano A.,
Hachinski Vladimir
Publication year - 2018
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2017.07.755
Subject(s) - dementia , vascular dementia , medicine , concomitant , pathology , population , disease , environmental health
The relative contributions of vascular and degenerative pathology to dementia are unknown. We aim to quantify the proportion of dementia explained by potentially preventable vascular lesions. Methods We systematically searched for population‐based cohorts before February 2017 reporting clinicopathological data for individuals with and without dementia. We calculated the summary proportion and absolute risk of dementia comparing subjects with and without the pathology. Results We identified 10 studies comprising 2856 subjects. Vascular‐type pathology and mixed pathology are respectively two and three times more likely in demented patients. The summary proportion of dementia is 77%–86% in subjects with mixed degenerative and vascular pathology and 45% in subjects with pure Alzheimer‐type pathology. Discussion Patients with mixed pathologies have nearly twice the incremental risk of dementia compared with patients with only Alzheimer‐type lesions. Consequently, many cases of dementia could be prevented or delayed by targeting the vascular component.