Friday, October 28, 2005

Why is Alzheimer’s disease getting all the attention?

This study published in Radiology, evaluating structural changes and cerebral blood flow in elderly demented patients compared with age-matched cognitively intact individuals, found reduced cerebral blood flow in the demented patients suggesting that vascular disease is an important factor in dementia in the elderly. We’ve gone through phases in our understanding of dementia. In the nineteenth century dementia was synonymous with general paresis of the insane, later understood to be caused by syphilis. A half century ago dementia was widely believed to be primarily a vascular disease, leading to a proliferation of vasodilators such as ergoloid mesylates, cyclandelate, and papaverine, none of which worked. More recently we’ve better appreciated Alzheimer’s disease. Does the article in Radiology bring us full circle with regard to “vascular dementia?” No, but it suggests that perhaps our emphasis on Alzheimer’s disease has lead to an under appreciation of vascular mechanisms. Here’s info on multi-infarct dementia and Binswanger’s dementia.

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