Research Institute for Brain and Blood Vessels Akita, Japan
Ken Nagata, M.D., PhD is graduated from Hirosaki University School of Medicine in 1978. From 1979-1983 neurologist in Institute of Brain & Blood Vessels Mihara Memorial Hospital. From 1983-1984 he is a research fellow in Department of Neurology, University of Colorado School of Medicine (USA). From 1884-2001 he is a scientist in Department of Neurology, Research Institute for Brain and Blood Vessels. From 2002-Present he is Director of Neurology at the Research Institute for Brain and Blood Vessels in Akita, Japan.
Epidemiological studies disclosed that there are common risk factors in Alzheimer’s disease (AD) and vascular dementia(VaD). Theycan beclassified into 4major categories: demographic, genetic, vascularand comorbidity risk factors. The demographic risk factorincludesgender, age, past history, years in educational and occupational attainment. Male gender is a risk for VaD and stroke, whereas female gender is known as a risk factor for AD. The genetic factors for VaD may include such familial VaD as CADASIL. ApoEε4is known to bethe possible common genetic factor for both VaD and AD.The lifestyle risk factors turn out to be obesity, lack of physical activity, cigarette smoking, excessive alcohol intake, and certain psychosocial factors. The vascular risk factors encompass hypertension in midlife, hypotension in late life, diabetes mellitus,dyslipidemia, congestive heart failure, myocardial infarction, arrhythmia, and chronic kidney disease. It is suggested that effective management of these vascularrisk factors may prevent onset of dementia and cognitive decline.Randomizedplacebo-controlled trials of antihypertensive drugsshowed that antihypertensive therapy may reduce the risk of VaD as well as AD. Low cardiac output due to hypotension and/or congestive heart failure has been regarded as a risk factor for cognitive impairment and dementia especially in elderlypatientswhose autoregulation of cerebral blood flow is impaired. Although further research is needed, those evidences may support a rationale for theefficacious management of vascular risk factors in the prevention of VaD as well as AD.
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