Assessment of Endothelial Function in Alzheimer's Disease: Is Alzheimer's Disease a Vascular Disease?

Authors

  • Didem Sener Dede MD,

    1. From the *Department of Internal Medicine, Department of Cardiology, and Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey§Department of Psychiatry, Ankara Oncology Hospital, Ankara, Turkey.
    Search for more papers by this author
  • Bunyamin Yavuz MD,

    1. From the *Department of Internal Medicine, Department of Cardiology, and Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey§Department of Psychiatry, Ankara Oncology Hospital, Ankara, Turkey.
    Search for more papers by this author
  • Burcu Balam Yavuz MD,

    1. From the *Department of Internal Medicine, Department of Cardiology, and Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey§Department of Psychiatry, Ankara Oncology Hospital, Ankara, Turkey.
    Search for more papers by this author
  • Mustafa Cankurtaran MD,

    1. From the *Department of Internal Medicine, Department of Cardiology, and Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey§Department of Psychiatry, Ankara Oncology Hospital, Ankara, Turkey.
    Search for more papers by this author
  • Meltem Halil MD,

    1. From the *Department of Internal Medicine, Department of Cardiology, and Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey§Department of Psychiatry, Ankara Oncology Hospital, Ankara, Turkey.
    Search for more papers by this author
  • Zekeriya Ulger MD,

    1. From the *Department of Internal Medicine, Department of Cardiology, and Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey§Department of Psychiatry, Ankara Oncology Hospital, Ankara, Turkey.
    Search for more papers by this author
  • Eylem Sahin Cankurtaran MD,

    1. From the *Department of Internal Medicine, Department of Cardiology, and Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey§Department of Psychiatry, Ankara Oncology Hospital, Ankara, Turkey.
    Search for more papers by this author
  • Kudret Aytemir MD,

    1. From the *Department of Internal Medicine, Department of Cardiology, and Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey§Department of Psychiatry, Ankara Oncology Hospital, Ankara, Turkey.
    Search for more papers by this author
  • Giray Kabakci MD,

    1. From the *Department of Internal Medicine, Department of Cardiology, and Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey§Department of Psychiatry, Ankara Oncology Hospital, Ankara, Turkey.
    Search for more papers by this author
  • Servet Ariogul MD

    1. From the *Department of Internal Medicine, Department of Cardiology, and Division of Geriatric Medicine, Department of Internal Medicine, Hacettepe University, Ankara, Turkey§Department of Psychiatry, Ankara Oncology Hospital, Ankara, Turkey.
    Search for more papers by this author

Address correspondence to Burcu Balam Yavuz, MD, Faculty of Medicine, Department of Internal Medicine, Division of Geriatric Medicine, Hacettepe University, Sihhiye, 06100 Ankara, Turkey.
E-mail: bbyavuz@hacettepe.edu.tr

Abstract

OBJECTIVES: To compare endothelial function of people with Alzheimer's disease (AD) with that of people without.

DESIGN: Case-control study.

SETTING: Geriatric medicine outpatient clinic of a university hospital.

PARTICIPANTS: Twenty-five patients with AD who were free of vascular risk factors and 24 healthy elderly controls were enrolled. Exclusion criteria were diabetes mellitus, hypertension, dyslipidemia, evident stroke, smoking, documented coronary artery disease, history of myocardial infarction, heart failure, acute or chronic infection, malignancy, peripheral artery disease, renal disease, rheumatologic diseases, alcohol abuse, and certain drugs that may affect endothelial function. Both groups underwent comprehensive geriatric assessment and neuropsychiatric assessment.

MEASUREMENTS: Endothelial function was evaluated according to flow-mediated dilation (FMD) from the brachial artery.

RESULTS: Mean age ± standard deviation was 78 ± 5.9 in the group with AD (11 female and 14 male) and 72.1 ± 5.8 in the control group (9 female and 11 male). Multiple linear regression analysis revealed that FMD was significantly lower in patients with AD (median 3.45, range 0–7) than controls (median 8.41, range 1–14) (P < .001), independent of age. It was also found that FMD values were inversely correlated with the stage of the disease as determined according to the Clinical Dementia Rating scale (r=−0.603, P < .001).

CONCLUSION: Endothelial function is impaired in patients with AD. Endothelial function was worse in patients with severe AD. These findings provide evidence that vascular factors have a role in the pathogenesis of AD.

Ancillary