Aggregate effects of vascular risk on neuropathology across the spectrum from
Alzheimer's disease to vascular dementia
 
   Lead Investigator:    Katherine Bangen
   Institution      :    University of California, San Diego
   E-Mail           :    kbangen@ucsd.edu
   Proposal ID      :    392



   Proposal Description:
   Vascular risk factors and cerebrovascular disease (CVD) have been linked to Alzheimer's disease (AD). Most studies examining the association between vascular risk and AD have focused on individual vascular risk factors, although multiple vascular risk factors often co-exist and have been shown to incrementally increase risk for AD. A recently published study using NACC data (Toledo et al., 2013) found that concurrent CVD is more common in AD than other neurodegenerative disorders (e.g., frontotemporal lobar degeneration due to tau, prion disease) and lowers the threshold for dementia due to AD. To improve our understanding of mechanisms linking vascular risk burden and dementia, the    proposed project will examine whether aggregate vascular risk exposure predicts different forms of vascular pathology and severity of cognitive impairment in patients with autopsy-based neuropathological diagnoses of 1) AD dementia 2) vascular dementia (VaD) 3) mixed AD/ VaD with AD primarily contributing 4) mixed VaD/ AD with VaD primarily contributing and 5) those with                   ???unremarkable brains??? and without cognitive impairment for comparison purposes. Unlike the recently published paper by Toledo and colleagues (2013) we will focus on patients across the spectrum from AD to mixed AD/VaD to VaD (rather than individuals with a single neurodegenerative disorder) and focus on   aggregate vascular risk burden (rather than comparing the frequency of individual vascular risk factors in the different neurodegenerative disorders).                                                                                                                                                                     The goals of this project are the following:                                      1) To determine whether aggregate vascular risk burden predicts vascular pathology and CVD at autopsy                                                      Vascular risk burden will be based on the absence