Alzheimer's disease, the leading cause of dementia in the elderly, is a neurodegenerative condition characterized by accumulation of amyloid plaques and neurofibrillary tangles in the brain. However, age-related vascular changes accompany or even precede the development of Alzheimer's pathology, raising the possibility that they may have a pathogenic role. This review provides an appraisal of the alterations in cerebral and systemic vasculature, the heart, and hemostasis that occur in Alzheimer's disease and their relationships to cognitive impairment. Although the molecular pathogenesis of these alterations remains to be defined, amyloid-β is a likely contributor in the brain as in the heart. Collectively, the evidence suggests that vascular pathology is a likely pathogenic contributor to age-related dementia, including Alzheimer's disease, inextricably linked to disease onset and progression. Consequently, the contribution of vascular factors should be considered in preventive, diagnostic, and therapeutic approaches to address one of the major health challenges of our time.

中文翻译：

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阿尔茨海默病和血管老化

阿尔茨海默病是老年人痴呆的主要原因，是一种神经退行性疾病，其特征是大脑中淀粉样斑块和神经原纤维缠结的积累。然而，与年龄相关的血管变化伴随或什至先于阿尔茨海默病的发展，增加了它们可能具有致病作用的可能性。本综述评估了阿尔茨海默病中脑和全身血管系统、心脏和止血的变化及其与认知障碍的关系。虽然这些改变的分子发病机制仍有待确定，但淀粉样蛋白 β 可能是大脑和心脏中的贡献者。总的来说，证据表明血管病理学可能是导致与年龄相关的痴呆症的致病因素，包括阿尔茨海默氏症 s 疾病，与疾病的发生和进展密不可分。因此，在预防、诊断和治疗方法中应考虑血管因素的贡献，以应对我们这个时代的主要健康挑战之一。