Abstract:
Background: Evidence from various consortia on vascular contributions has been inconsistent in determining the etiology
of sporadic Alzheimer’s disease (AD).
Objective: To investigate vascular risk factors and cerebrovascular pathologies associated in manifestation of AD-related
neuropathological changes of an elderly population.
Methods: Postmortem brain samples from 76 elderly subjects (>50 years) were used to study genetic polymorphisms,
intracranial atherosclerosis of the circle of Willis (IASCW), and microscopic infarcts in deep white matters. From this cohort,
50 brains (>60 years) were subjected to neuropathological diagnosis using immunohistopathological techniques.Results: Besides the association with age, the apolipoprotein E e4 allele was significantly and strongly associated with
Thai amyloid-p phases >1 [odds ratio (OR) = 6.76, 95% confidence interval (Cl) 1.37-33.45] and inversely with Braak
neurofibrillary tangle (NFT) stages >111 (0.02,0.0-0.47). Illiterates showed a significant positive association for Braak NFT
stages >IV (14.62, 1.21-176.73) and a significant negative association for microscopic infarcts (0.15, 0.03-0.71) in deep
white matters. With respect to cerebrovascular pathologies, cerebral small vessel lesions (white matter hyperintensities and
cerebral amyloid angiopathy) showed a higher degree of associations among them and with AD-related neuropathological
changes (p < 0.05) compared to large vessel pathology (IASCW), which showed a significant association only with Braak
NFT stages >1 (p = 0.050).
Conclusion: These findings suggest that besides age, education, and genetic factors, other vascular risk factors were not
associated with AD-related neuropathological changes and urge prompt actions be taken against cerebral small vessel diseases
since evidence for effective prevention is still lacking.
