The latest authoritative international research reveals a long-neglected truth: among patients diagnosed with Alzheimer's disease, up to 75% exhibit not only typical neurodegenerative changes but also concurrent cerebrovascular damage in their brains.
These two types of lesions do not act independently, but rather collude and collaborate to accelerate the collapse of memory. This means that to combat cognitive decline, it is not sufficient to focus solely on "brain nutrition" or "brain-enhancing games". We must launch a dual-line defense war targeting both "nerves" and "blood vessels".
This article will break down this core discovery for you based on the authoritative editorial from the top international journal, the British Journal of Pharmacology, and provide a clear, science-based action guide.
Core truth: Mixed dementia is the norm
For a long time, Alzheimer's Disease (AD) and Vascular Dementia (VaD) have been regarded as two separate diseases. However, cutting-edge medical perspectives are now challenging this perception:
1. "Pure" cases are rare: Studies indicate that dementia with "pure" Alzheimer's disease (AD) pathology or "pure" vascular pathology is relatively uncommon.
2. Mixed pathology is prevalent: In the brains of most patients, there is a coexistence of β-amyloid plaques/tau tangles (pathological markers of Alzheimer's Disease, AD) and cerebral microbleeds and microinfarcts (markers of vascular damage).
3. Lethal synergistic effect: These two pathologies are not simply additive; they interact with each other, producing a destructive force where "1+1>2", accelerating and intensifying cognitive decline.
Why is this discovery so important? Because it directly ties "brain health" closely to the "cardiovascular and cerebrovascular health" that everyone is familiar with.
Faced with the complex symptoms of their family members, many relatives may be confused: is this Alzheimer's Disease (AD) or stroke sequelae? The following table, based on research and clinical experience, provides a clear breakdown for you:
The most important association: The study clearly indicates that Alzheimer's Disease (AD) and vascular lesions are by no means two parallel lines. Vascular risk factors, such as hypertension, not only lead to vascular dementia (VaD), but also "pave the way" or "accelerate" the onset of AD by damaging cerebral blood vessels, reducing cerebral blood flow, and inducing inflammation. This is precisely the pathological basis of "mixed dementia".
Action Guide: "Prevention" and "Protection" from a New Perspective
After understanding the aforementioned connections, our coping strategies must be upgraded. The following suggestions are all based on the intervenable directions mentioned in the research:
First line of defense: "Primary prevention" that everyone can do
A report from a sub-journal of The Lancet indicates that approximately 65% of dementia cases can be prevented by intervening in risk factors. For everyone, especially middle-aged individuals:
Strictly manage the "three highs": Regard controlling blood pressure, blood sugar, and blood lipids as "compulsory courses" for protecting memory, rather than merely as cardiovascular tasks.
Embrace a healthy lifestyle: adhere to regular exercise (such as brisk walking, swimming), adopt a Mediterranean diet (rich in fruits and vegetables, whole grains, olive oil), quit smoking and limit alcohol consumption, and maintain social and cognitive activities.
Second front: "Collaborative management" of confirmed patients
If family members have developed symptoms, on the basis of professional diagnosis and treatment, family members should have a "dual management" awareness:
1. During diagnosis: Actively communicate with the doctor to understand the coexistence of vascular lesions (such as white matter lesions, lacunar lesions) in the MRI results of the head, as this directly affects the overall treatment plan.
2. During treatment: While following the doctor's advice for symptomatic treatment of AD, the prevention of cerebrovascular disease must be given equal importance. This means:
- Control blood pressure more strictly than ordinary people (the target value needs to be determined by a doctor).
- Under the assessment of a doctor, antiplatelet drugs (such as aspirin) or anticoagulant drugs may be needed to prevent stroke recurrence. (Please note: Anticoagulant therapy is mentioned in the literature as a frontier exploration direction, but specific medication must be determined after rigorous assessment by a neurologist, and self-medication is absolutely prohibited.).
3. During nursing care: Be vigilant for "stepwise" deterioration. If the patient's cognitive ability suddenly and significantly decreases, seek immediate medical attention to rule out the possibility of a new silent stroke.
Hainan Chengmei Hospital's Memory Clinic integrates professional resources from multiple fields to provide patients with comprehensive, precise, and personalized diagnosis and treatment services.
Expert Introduction
Dai Wenxin, Chief Physician
Executive Director of the Multidisciplinary Geriatrics Diagnosis and Treatment Center
Professor, PhD candidate
Postdoctoral researcher, master's supervisor
Medical expertise:
I. Diagnosis and treatment of Alzheimer's disease and other geriatric diseases
II. Diagnosis and treatment of diseases across multiple disciplines, including respiratory system, cardiovascular system, nervous system, and geriatric diseases
III. Genetic diagnosis, chemotherapy, targeted therapy, immunotherapy, microenvironment analysis, and integrated precision treatment of tumors
IV. Genetic diagnosis and precision treatment of hypertension, hyperlipidemia, hyperuricemia, and hyperglycemia
V. New biomedical technologies such as stem cells and gene programming, as well as new technologies like insulin pumps and diabetes reversal
VI. High-intensity focused ultrasound (HIFU) therapy for benign and malignant tumors
VII. Microbial therapy of intestinal flora for chronic diseases and mental and psychological disorders
VIII. Diagnostic and therapeutic techniques under medical endoscopes such as bronchoscope, mediastinoscope, and thoracoscope
IX. Sleep medicine
X. Chronic disease management
Clinic Hours: Monday and Wednesday morning
Source | WeChat official account of Professor Han Ying's team at Xuanwu Hospital