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 Mix of Disease Processes at Work in Brains of Most People wi

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PostSubject: Mix of Disease Processes at Work in Brains of Most People wi   Fri Sep 21, 2007 12:01 am

Mix of Disease Processes at Work in Brains of Most People with Dementia




BETHESDA, MD -- June 14, 2007 -- Few older people die with
brains untouched by a pathological process, however, an individual's
likelihood of having clinical signs of dementia increases with the
number of different disease processes present in the brain, according
to a new study.



The research was funded by the National Institute on Aging (NIA), part
of the National Institutes of Health, and conducted at the Rush
Alzheimer's Disease Center at Rush University Medical Center in
Chicago. Julie Schneider, MD, and colleagues report the findings in the
journal Neurology online today.



Among their findings is the observation that the combination of
Alzheimer's disease and strokes is the most common mix of pathologies
in the brains of people with dementia. The implication of these
findings is that public health efforts to prevent and treat vascular
disease could potentially reduce the occurrence of dementia, the
researchers say in the paper.



The researchers used data from the Rush Memory and Aging Project an
ongoing study of 1,200 elderly volunteers who have agreed to be
evaluated every year and to donate their brains upon death.



The current study compared clinical and autopsy data on the first 141 participants who have died.



Annual physical and psychological exams showed that, while they were
alive, 50 of the 141 had dementia. Upon death, a neuropathologist, who
was unaware of the results of the clinical evaluation, analyzed each
person's brain. The autopsies showed that about 85% of the individuals
had evidence of at least one chronic disease process, such as
Alzheimer's disease, strokes, Parkinson's disease, hemorrhages, tumors,
traumatic brain injury or others.



Comparison of the clinical and autopsy results showed that only 30% of
people with signs of dementia had Alzheimer's disease alone. By
contrast, 42% of the people with dementia had Alzheimer's disease with
infarcts and 16% had Alzheimer's disease with Parkinson's disease
(including two people with all three conditions). Infarcts alone caused
another 12% of the cases. Also, 80 of the 141 volunteers who died had
sufficient Alzheimer's disease pathology in their brains to fulfill
accepted neuropathologic criteria for Alzheimer's disease, although in
life only 47 were clinically diagnosed with probable or possible
Alzheimer's disease.



"We know that people can have Alzheimer's pathology
without having symptoms," says Dallas Anderson, PhD, population studies
program director in the NIA Neuroscience and Neuopsychology of Aging
Program. "The finding that Alzheimer's pathology with cerebral infarcts
is a very common combination in people with dementia adds to emerging
evidence that we might be able to reduce some of the risk of dementia
with the same tools we use for cardiovascular disease such as control
of blood cholesterol levels and hypertension."




NIA is conducting clinical trials to determine whether interventions
for cardiovascular disease can prevent or slow the progress of
Alzheimer's disease. On-going trials cover a range of interventions
such as statin drugs, vitamins and exercise.
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