Donna Wilcock, Ph.D., of the Sanders-Brown Center on Aging at the University of Kentucky, has co-authored a paper that offers a roadmap for future research into the interaction between vascular disease and Alzheimer's.

The article in-press, which aims to encourage researchers to fill gaps in the current knowledge of how Alzheimer’s and vascular conditions progress together and influence each other, was published online by "Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association."

A growing body of research suggests that the most common cause of dementia in older people is a mix of vascular and Alzheimer’s-related brain abnormalities, and that approximately half of the people who die with Alzheimer’s also have evidence of strokes in their brains. Furthermore, when strokes and hallmark Alzheimer’s plaques and tangles are combined, it increases a person’s likelihood of experiencing dementia. Stroke, or as it is known more generally as cerebrovascular disease, occurs with aging and is made worse by conditions like smoking, hypertension or diabetes.

“Inadequate blood flow can damage and eventually kill cells anywhere in the body, and since the brain has one of the body's richest networks of blood vessels, it is especially vulnerable," Wilcock said.

"Considering this and demonstrated success in reducing risk for heart disease, stroke and other vascular-related diseases through healthy lifestyle modifications and use of medications, it only makes sense to increase our understanding of the role vascular factors play in Alzheimer’s and dementia.”

In December 2013, the Alzheimer’s Association, with scientific input from the National Institutes of Health’s National Institute of Neurological Disorders and Stroke (NINDS) and National Heart, Lung and Blood Institute (NHLBI), convened a group of scientific experts to discuss the scientific findings to date and gaps in research on vascular contributions in Alzheimer’s and related forms of dementia. The newly published article summarizes the meeting and discussions, including an outline of next steps.

"This group put together some very important recommendations for the future direction of research on vascular contributions to cognitive impairment and dementia," said Linda Van Eldik, Ph.D., director of the Sanders-Brown Center on Aging. "It is a reflection of Donna's capabilities that she was included in the panel, and an honor to have Sanders-Brown represented in the process."

The authors of the article recommend filling gaps in several key areas of research, including:

·      The relationship between diabetes and insulin resistance and risk of vascular disease, Alzheimer’s and related dementia.

·      Genetic factors that may influence vascular processes and other changes in the brain.

·      Impact of immune system response on blood flow in the brain in the progression of Alzheimer’s disease.

·      The role of fat breakdown in the brain in the removal of amyloid build-up that leads to the hallmark brain plaques in Alzheimer’s disease.

·      Controlling the impact of vascular risk factors on memory and thinking abilities.

“Future investment for these areas of scientific discovery will be essential to galvanize the scientific community and provide forums of communication between the dementia and vascular fields,” the authors state in the paper.

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