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Alzheimer disease as a vascular disorder: nosological evidence
de la Torre JC.. Stroke, 2002-04-01
Topic: Amyloid, tau and blood-test diagnosis
Background The main stumbling block in the clinical management and in the search for a cure of Alzheimer disease (AD) is that the cause of this disorder has remained uncertain until now. Summary of review Evidence that sporadic (nongenetic) AD is primarily a vascular rather than a neurodegenerative disorder is reviewed. This conclusion is based on the following evidence: (1) epidemiological studies showing that practically all risk factors for AD reported thus far have a vascular component that reduces cerebral perfusion; (2) risk factor association between AD and vascular dementia (VaD); (3) improvement of cerebral perfusion obtained from most pharmacotherapy used to reduce the symptoms or progression of AD; (4) detection of regional cerebral hypoperfusion with the use of neuroimaging techniques to preclinically identify AD candidates; (5) presence of regional brain microvascular abnormalities before cognitive and neurodegenerative changes; (6) common overlap of clinical AD and VaD cognitive symptoms; (7) similarity of cerebrovascular lesions present in most AD and VaD patients; (8) presence of cerebral hypoperfusion preceding hypometabolism, cognitive decline, and neurodegeneration in AD; and (9) confirmation of the heterogeneous and multifactorial nature of AD, likely resulting from the diverse presence of vascular risk factors or indicators of vascular disease. Conclusions Since the value of scientific evidence generally revolves around probability and chance, it is concluded that the data presented here pose a powerful argument in support of the proposal that AD should be classified as a vascular disorder. According to elementary statistics, the probability or chance that all these findings are due to an indirect pathological effect or to coincidental circumstances related to the disease process of AD seems highly unlikely. The collective data presented in this review strongly support the concept that sporadic AD is a vascular disorder. It is recommended that current clinical management of patients, treatment targets, research designs, and disease prevention efforts need to be critically reassessed and placed in perspective in light of these important findings.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
de la Torre, J. C. (2002). Alzheimer disease as a vascular disorder: nosological evidence. Stroke. https://doi.org/10.1161/01.str.0000014421.15948.67
Vancouver
de la Torre JC. Alzheimer disease as a vascular disorder: nosological evidence. Stroke. 2002. doi:10.1161/01.str.0000014421.15948.67. PMID: 11935076.
BibTeX
@article{delatorre2002-11935076,
author = {de la Torre, J. C.},
title = {{Alzheimer disease as a vascular disorder: nosological evidence}},
journal = {Stroke},
year = {2002},
doi = {10.1161/01.str.0000014421.15948.67},
pmid = {11935076},
url = {https://doi.org/10.1161/01.str.0000014421.15948.67}
}
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Key findings
- Conclusions Since the value of scientific evidence generally revolves around probability and chance, it is concluded that the data presented here pose a powerful argument in support of the proposal that AD should be classified as a vascular disorder.
- According to elementary statistics, the probability or chance that all these findings are due to an indirect pathological effect or to coincidental circumstances related to the disease process of AD seems highly unlikely.
Why it matters
This review argues that sporadic Alzheimer's disease should be classified as a vascular rather than a neurodegenerative disorder, based on evidence such as vascular risk factors reducing cerebral perfusion and cerebral hypoperfusion preceding cognitive decline and neurodegeneration. It concludes that the data pose a powerful argument for this reclassification, but reports no treatment, cure or prevention.
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Study details
- Evidence strengthLow
How this study scored 48/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomized / blinded because the record does not state it. We have no data on impact for its field and year, so that was left out: it earned 45 of the 94 points we could judge it on, which is 48 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Stroke) |
| Journal's citation record | 3 / 4 | Stroke: journal h-index 455 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2002 — older than 20 years, still counted |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 854 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 32.8 citations a year over 26 year(s) since 2002 |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | 4 / 6 | Cited by 40 other studies in this library |
| Still being cited | 3 / 4 | Cited 56 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author J. C. de la Torre: h-index 37 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of California San Diego: institution h-index 1,852 (OpenAlex) |
| Multicenter collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 11935076) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 45 / 94 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 45 of the 94 points we could judge it on is 48 out of 100. |
| Total | 48 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1161/01.str.0000014421.15948.67
- PubMed: 11935076
- Original source →
- Free full text: ahajournals.org →
Full text: free to read — Unpaywall lists this copy as free to read: the link above (checked 10 Oct 2026).
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