Home › Research › Lewy body dementia
The overlap between vascular disease and Alzheimer's disease--lessons from pathology
Attems J, Jellinger KA.. BMC medicine, 2014-11-11
Topic: Amyloid, tau and blood-test diagnosis
Recent epidemiological and clinico-pathological data indicate considerable overlap between cerebrovascular disease (CVD) and Alzheimer's disease (AD) and suggest additive or synergistic effects of both pathologies on cognitive decline. The most frequent vascular pathologies in the aging brain and in AD are cerebral amyloid angiopathy and small vessel disease. Up to 84% of aged subjects show morphological substrates of CVD in addition to AD pathology. AD brains with minor CVD, similar to pure vascular dementia, show subcortical vascular lesions in about two-thirds, while in mixed type dementia (AD plus vascular dementia), multiple larger infarcts are more frequent. Small infarcts in patients with full-blown AD have no impact on cognitive decline but are overwhelmed by the severity of Alzheimer pathology, while in early stages of AD, cerebrovascular lesions may influence and promote cognitive impairment, lowering the threshold for clinically overt dementia. Further studies are warranted to elucidate the many hitherto unanswered questions regarding the overlap between CVD and AD as well as the impact of both CVD and AD pathologies on the development and progression of dementia.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Attems, J., & Jellinger, K. A. (2014). The overlap between vascular disease and Alzheimer's disease--lessons from pathology. BMC medicine. https://doi.org/10.1186/s12916-014-0206-2
Vancouver
Attems J, Jellinger KA. The overlap between vascular disease and Alzheimer's disease--lessons from pathology. BMC medicine. 2014. doi:10.1186/s12916-014-0206-2. PMID: 25385447.
BibTeX
@article{attems2014-25385447,
author = {Attems, J. and Jellinger, K. A.},
title = {{The overlap between vascular disease and Alzheimer's disease--lessons from pathology}},
journal = {BMC medicine},
year = {2014},
doi = {10.1186/s12916-014-0206-2},
pmid = {25385447},
url = {https://doi.org/10.1186/s12916-014-0206-2}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- The most frequent vascular pathologies in the aging brain and in AD are cerebral amyloid angiopathy and small vessel disease.
- Up to 84% of aged subjects show morphological substrates of CVD in addition to AD pathology.
- AD brains with minor CVD, similar to pure vascular dementia, show subcortical vascular lesions in about two-thirds, while in mixed type dementia (AD plus vascular dementia), multiple larger infarcts are more frequent.
- Small infarcts in patients with full-blown AD have no impact on cognitive decline but are overwhelmed by the severity of Alzheimer pathology, while in early stages of AD, cerebrovascular lesions may influence and promote cognitive impairment, lowering the threshold for clinically overt dementia.
- Further studies are warranted to elucidate the many hitherto unanswered questions regarding the overlap between CVD and AD as well as the impact of both CVD and AD pathologies on the development and progression of dementia.
Why it matters
This review of brain-pathology evidence reports that "up to 84%" of older people examined show blood-vessel damage alongside Alzheimer's changes, most often cerebral amyloid angiopathy and small vessel disease; the record does not say which group of brains that upper figure comes from. It describes small strokes as having no added effect on decline once Alzheimer's is advanced, because they are "overwhelmed by the severity of Alzheimer pathology", while in early stages vascular lesions "may" lower the threshold for dementia. This is a summary of existing findings that "suggest" the two kinds of damage add up; it is not a trial and does not show that treating vascular disease prevents Alzheimer's.
Study details
- Evidence strengthLow
How this study scored 56/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (BMC medicine) |
| Journal's citation record | 3 / 4 | BMC Medicine: journal h-index 259 (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 | 2014 — within 20 year(s) of the newest study here |
| 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) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 737 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 52.6 citations a year over 14 year(s) since 2014 |
| Impact for its field and year | 5 / 6 | Cited 26.9× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 4 / 6 | Cited by 46 other studies in this library |
| Still being cited | 4 / 4 | Cited 203 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author K. A. Jellinger: h-index 137 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Newcastle University: institution h-index 932 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 2 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 25385447) |
| Free to read | 2 / 2 | Free to read |
| Total | 56 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Related
Studies in the library that share something with this one. The line above each title says what.
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here. Showing 12 of 48.
Later studies that cite this one
46 studies in the alzhub library list this one in their references. Showing the 8 highest-scoring.
Related studies in Lewy body dementia
Also in Lewy body dementia
39 studies in the library are filed under Lewy body dementia with no topic tag they share with another; these are this study's neighbours in a fixed tour of them. The Lewy body dementia hub.