Vascular contributions to Alzheimer's disease.
Level 5 - mechanism / opinion, no new human data
Narrative review discussing mechanisms and hypotheses without systematic review or new primary human data.
PubMed 36529160 · doi:10.1016/j.trsl.2022.12.003
What was done
This narrative review synthesizes proposed pathological pathways linking cardiovascular disease and vascular dysfunction to Alzheimer's disease. The authors describe mechanisms including dysregulation of neurovascular coupling, disruption of the blood-brain barrier, reduced clearance of beta-amyloid, the two-hit hypothesis, and neuroimaging indicators such as chronic cerebral hypoperfusion and cerebral amyloid angiopathy.
What was found
The abstract reports no numerical findings or effect sizes. It qualitatively describes that signs of vascular dysfunction (such as chronic cerebral hypoperfusion) appear early in Alzheimer's disease before cognitive decline and traditional biomarker alterations, and that cerebral small vessel disease is prevalent in both vascular dementia and Alzheimer's disease. The literature remains unclear on whether cardiovascular disease causes, precipitates, amplifies, precedes, or coincides with Alzheimer's disease.
Why it matters
It outlines how microvascular damage interacts with classic Alzheimer's pathology and emphasizes the need for quantitative vascular neuroimaging to clarify causal timelines.
Limits
The paper is a narrative review with no systematic search methodology, no quantitative synthesis, and no primary human data or sample sizes reported in the abstract.
Cited by
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