Alzheimer Disease: Gorelick PB

Iadecola C, Gorelick PB. · Division of Neurobiology, Department of Neurology and Neuroscience, Weill Medical College of Cornell University, New York, NY 10021, USA. · Stroke. · Pubmed #12574528 links to  free full text

This publication has no abstract.

Gorelick PB. · Department of Neurology and Rehabilitation, University of Illinois College of Medicine at Chicago, Chicago, Ill 60612, USA. · Stroke. · Pubmed #15731466 links to  free full text

Abstract: BACKGROUND AND PURPOSE: Vascular risk factors are common in the elderly, and some such as hypertension may be important predictors of cognitive impairment. SUMMARY OF REVIEW: In this article, the role that vascular risk factors may play in the prevention of vascular and nonvascular forms of cognitive impairment is reviewed. CONCLUSIONS: Because vascular risk factors may have negative effects on brain structure and cognitive function, and because vascular risk factors may be present in midlife or possibly earlier, we may need to develop long-term intervention strategies to control or prevent vascular risk factors in an effort to preserve cognitive vitality as we age.

Gorelick PB. · Department of Neurology and Rehabilitation, University of Illinois College of Medicine at Chicago, 912 South Wood St, Room 855N, Chicago, IL 60612, USA. · Stroke. · Pubmed #15375299 links to  free full text

Abstract: Alzheimer disease and vascular cognitive impairment are important causes of cognitive decline in the elderly. It has now been shown that vascular risk factors have measurable negative effects on the brain and are associated with cognitive impairment. We review vascular factors that might be responsible to cognitive decline in Alzheimer disease and vascular cognitive impairment and the corresponding interventions that might prevent cognitive impairment as we age.

Gorelick PB, Erkinjuntti T, Hofman A, Rocca WA, Skoog I, Winblad B. · Department of Neurological Sciences, Rush Medical College, Chicago, Illinois, USA. · Alzheimer Dis Assoc Disord. · Pubmed #10609692 No free full text.

Abstract: Stroke is an important public health problem worldwide. Those at high risk of stroke may be at high risk of cognitive impairment and dementia after stroke. Modifiable cardiovascular risk factors in midlife including hypertension, alcohol use, cigarette smoking, and certain dietary factors may be important targets for prevention of vascular causes of cognitive impairment. These same types of factors may also be associated with Alzheimer disease. Better control of cardiovascular disease risk factors might lead to delay or prevention of vascular dementia and Alzheimer disease.

Pytel P, Cochran EJ, Bonner G, Nyenhuis DL, Thomas C, Gorelick PB. · Department of Pathology, The University of Chicago, IL, USA. · Neurology. · Pubmed #16476949 No free full text.

Abstract: The authors studied 13 autopsy brains from a larger cohort of 270 African-Americans with a clinical diagnosis of Alzheimer disease (AD), vascular dementia (VaD), or stroke without dementia. Two subjects exhibited changes of pure VaD, 5 had pure AD, and 6 showed a mixture of AD pathology and strokes. Overall, there was good agreement between the pathologic diagnoses and the clinical diagnoses.

Freels S, Nyenhuis DL, Gorelick PB. · Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL 60612-4336, USA. · Neurology. · Pubmed #12391341 No free full text.

Abstract: BACKGROUND: A hospital-based cohort of African American patients in the Chicago area with AD, vascular dementia (VaD), or stroke without dementia (SWD) were followed for up to 7 years. OBJECTIVE: To describe and analyze predictors of survival in this cohort. METHODS: Proportional hazards regression models were used to analyze risk of death in 113 patients with AD (53 deaths), 79 patients with VaD (31 deaths), and 56 patients with SWD (14 deaths). RESULTS: Patients with AD who were older and had more years of education and lower Barthel ADL scores were at higher risk of death. Patients with VaD who were taking antihypertensive medication were at higher risk of death; those who were taking aspirin or antiplatelet/anticoagulant medication were at lower risk of death; and higher diastolic blood pressure was protective against death. Risk factors for death in the SWD group were older age, having ever been a smoker, and history of atrial fibrillation. Differences in survival across the three groups were not significant after adjusting for age and clinical dementia rating. CONCLUSIONS: Results in patients with VaD support the use of antiplatelet therapy for persons with VaD and suggest that optimal blood pressure may be higher in cognitively compromised poststroke patients than persons in the general population.

Nyenhuis DL, Gorelick PB, Freels S, Garron DC. · Center for Stroke Research, Department of Neurological Sciences, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612, USA. · Neurology. · Pubmed #11781406 No free full text.

Abstract: OBJECTIVE: To compare the rates of cognitive and functional decline in African American patients diagnosed at baseline with vascular dementia (VaD) (n = 79), AD (n = 113), or stroke without dementia (SWD) (n = 56) and followed for up to 7 years with annual neuropsychological and other examinations. METHODS: Study patients were diagnosed using established criteria for dementia and were administered cognitive screening, functional screening, and neuropsychological measures. Baseline dementia severity was rated using the Clinical Dementia Rating Scale. Random effects modeling was used to examine rates of decline and to compare the rates of decline in the three groups. RESULTS: Both patients with VaD and those with AD showed significant cognitive and functional decline during follow-up; patients with VaD declined at a slower rate than patients with AD; and patients diagnosed with SWD at baseline did not show cognitive or functional decline during follow-up. CONCLUSIONS: Patients with VaD decline at a slower rate than patients with AD. Patients who do not meet criteria for dementia soon after stroke may not be at high risk for developing dementia. Future studies are needed to follow VaD patients with longitudinal, specialized MR protocols, concurrent neuropsychological examinations, and neuropathologic examination to determine possible neuroimaging predictors of progressive cognitive and functional decline and to assess the contribution of Alzheimer's pathology to decline in patients diagnosed with VaD.