Summary: Dr. Vladimir Hachinski, a prominent stroke researcher, says the vascular cognitive impairment that can coexist with Alzheimer’s is too often ignored. There is good evidence that Alzheimer’s disease and the strokes that cause vascular cognitive impairment share the same treatable risk factors (high blood pressure, “hardening of the arteries,” etc.). By treating those risk factors, you can reduce your risk of stroke, and maybe reduce your risk of Alzheimer’s as well.
Stroke and Alzheimer’s disease: partners in crime
Although many of us worry about developing Alzheimer’s, Dr. Hachinski thinks Alzheimer’s plaques and tangles are only part of the story. It’s common for people with memory loss to have signs of stroke along with Alzheimer’s disease. “Stroke and Alzheimer’s are partners in crime,” he says.
Dr. Hachinski believes the two conditions interact, at least in some people. He cites evidence from the Nun Study, which suggests that damage from stroke may interact with Alzheimer’s pathology to increase the severity of memory loss.
He and his colleagues found that rats with both stroke-like and Alzheimer’s-like pathologies have more inflammation, more damaged areas of the brain and more cognitive problems than those with stroke-like pathologies only. In their study, these problems got worse over time, whereas the damage from stroke-like pathology decreased over time. They plan to study humans to see if there is the same effect.
This connection between stroke and Alzheimer’s is under-appreciated, he thinks, because Alzheimer’s doctors tend to focus on Alzheimer’s, while stroke doctors focus mainly on stroke. In addition, screening tests typically measure memory loss, but not the problems with planning, multitasking and judgment that Dr. Hachinski says are typically caused by stroke.
Preventing strokes may prevent Alzheimer’s too
Diseases that contribute to strokes can be treated or prevented with lifestyle improvements and medicines, says Dr. Hachinski. A study by Harvard researchers estimates healthy lifestyles can prevent half of all ischemic strokes.
The same diseases (high blood pressure, “hardening of the arteries,” etc.) that are risk factors for stroke are thought to be risk factors for Alzheimer’s as well. “Therefore, we should try to not only prevent stroke, but test the very well-based hypothesis that we can delay Alzheimer disease by doing so,” he says.
What you can do
For people who want to reduce their risk of both Alzheimer’s and strokes, Dr. Hachinski has some advice. “Know your risk,” he says. “Family history matters as well as lifestyle and risk factor control. A first step is to be evaluated medically to establish the degree of risk. Then, do something about your risk. Clearly if there are treatable factors, they should be addressed vigorously.”
He notes you have the most to gain from preventive treatment if you have the APOE4 genetic variation that puts you at greater risk for developing Alzheimer’s. If you also have high blood pressure, that risk is multiplied. Treatment would benefit you the most because it can decrease your risk to close to that of people with normal blood pressure who do not have the APOE4 variation.
Vladimir Hachinski, MD, FRCPC, DSc
Stroke and Alzheimer’s disease: partners in crime
Although many of us worry about developing Alzheimer’s, Dr. Hachinski thinks Alzheimer’s plaques and tangles are only part of the story. It’s common for people with memory loss to have signs of stroke along with Alzheimer’s disease. “Stroke and Alzheimer’s are partners in crime,” he says.
Dr. Hachinski believes the two conditions interact, at least in some people. He cites evidence from the Nun Study, which suggests that damage from stroke may interact with Alzheimer’s pathology to increase the severity of memory loss.
He and his colleagues found that rats with both stroke-like and Alzheimer’s-like pathologies have more inflammation, more damaged areas of the brain and more cognitive problems than those with stroke-like pathologies only. In their study, these problems got worse over time, whereas the damage from stroke-like pathology decreased over time. They plan to study humans to see if there is the same effect.
This connection between stroke and Alzheimer’s is under-appreciated, he thinks, because Alzheimer’s doctors tend to focus on Alzheimer’s, while stroke doctors focus mainly on stroke. In addition, screening tests typically measure memory loss, but not the problems with planning, multitasking and judgment that Dr. Hachinski says are typically caused by stroke.
Preventing strokes may prevent Alzheimer’s too
Diseases that contribute to strokes can be treated or prevented with lifestyle improvements and medicines, says Dr. Hachinski. A study by Harvard researchers estimates healthy lifestyles can prevent half of all ischemic strokes.
The same diseases (high blood pressure, “hardening of the arteries,” etc.) that are risk factors for stroke are thought to be risk factors for Alzheimer’s as well. “Therefore, we should try to not only prevent stroke, but test the very well-based hypothesis that we can delay Alzheimer disease by doing so,” he says.
What you can do
For people who want to reduce their risk of both Alzheimer’s and strokes, Dr. Hachinski has some advice. “Know your risk,” he says. “Family history matters as well as lifestyle and risk factor control. A first step is to be evaluated medically to establish the degree of risk. Then, do something about your risk. Clearly if there are treatable factors, they should be addressed vigorously.”
He notes you have the most to gain from preventive treatment if you have the APOE4 genetic variation that puts you at greater risk for developing Alzheimer’s. If you also have high blood pressure, that risk is multiplied. Treatment would benefit you the most because it can decrease your risk to close to that of people with normal blood pressure who do not have the APOE4 variation.
