Relevance of Cardiovascular Risk Factors and Ischemic Cerebrovascular Disease to the Pathogenesis of Alzheimer Disease A Review of Accrued Findings From the Honolulu-Asia Aging Study

摘要

During the mid-1960s, Robert Katzman and Robert Terry pointed out that the clinical and neuropatho-logic features of the most common forms of severe cognitive impairment in late life were fundamentally the same as those of Alzheimer "presenile" dementia,. Previously, most of the declines in cognition after age 65 had been informally attributed to "senility," commonly thought of as due to "hardening of the arteries," The neurofibrillary tangles (NFT) and amyloid deposits of Alzheimer disease (AD) are, of course, quite distinct from atherosclerotic, arteriosclerotic, and focal ischemic cerebrovascular disease, Katzman and Terry's observations precipitated an abrupt change in thinking. It became inappropriate to dismiss senility as due to normal brain aging, or to the declines in blood flow to the brain associated with generalized atherosclerosis. Over the following 2 decades, AD became nearly synonymous with late-life dementia, and consideration of a role for ischemia in the development of AD was widely dismissed as out of step with modem thinking.