BMJ 1994;309:411 (6 August)

Letters

Atherosclerotic disease and cognitive decline

EDITOR, - Monique M B Breteler and colleagues describe an association between the clinical manifestations of atherosclerotic disease and cognitive decline in elderly people. They conclude that atherosclerotic disease may account for considerable cognitive impairment and suggest it is time to study whether population wide atherosclerotic risk factor intervention can prevent such cognitive decline.1

The assumption made is that the potentially modifiable atherosclerotic process is the major determinant of the observed cognitive impairment. This may be so for "multi-infarct" dementia, but in many patients cognitive impairment will be due to Alzheimer's disease. As with atherosclerosis, this condition probably evolves from a complex interaction of genetic and environmental factors but is unlikely to respond to conventional risk factor modification. However, one common pathogenic mechanism may link these apparently distinct entities.

The e4 allele of apolipoprotein E has been independently linked with both atherosclerosis and Alzheimer's disease. Carriage of the e4 allele . . . [Full text of this article]


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Relevant Article

Cardiovascular disease and distribution of cognitive function in elderly people: the Rotterdam study
M M B Breteler, J J Claus, D E Grobbee, and A Hofman
BMJ 1994 308: 1604-1608. [Abstract] [Full Text]

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