Hypertension and Diabetes in Alzheimers disease and Vascular

Hypertension and Diabetes in Alzheimer´s disease and Vascular Dementia – Common Denominators? K Javanshiri, K Wickerström, F Sjövall, N Friberg, M Haglund, M Landqvist Waldö, E Englund. From the Div of Oncology and Pathology, Lund/ the Div of Clinical Sciences, Helsingborg, Department of Clinical Sciences, Lund University, Sweden INTRODUCTION: It has been suggested that Alzheimer´s disease (AD) and vascular dementia (Va. D) share common risk factors, especially cardiovascular risk factors. The aim of this study was to investigate the prevalence of hypertension (HT) and diabetes (DM) in neuropathologically defined cases of AD, AD-Va. D dementia; mixed dementia (MD) and Va. D in 268 subjects. METHODS: Autopsy reports from the clinical department of Pathology in Lund from 1992 -2017 were analyzed. All cases with a complete autopsy report and a neuropathologically diagnosed dementia disorder of AD, MD or Va. D were selected. A prerequisite was a clinical diagnosis of neurocognitive disease/dementia. Clinical data were retrieved from the medical records and the Swedish National Diabetes Register (NDR). 1 A total of 268 subjects were included. Dementia Diagnosis Patients, n (%) Women % Age at Death All Patients 268 (100) 58 82 (71 -93) AD 81 (30) 62 80 (64 -96) MD 81 (30) 67 83 (73 -93) Va. D 106 (40) 6 81 (71 -91) PATHOLOGY DEFINITIONS OF DEMENTIA SUBTYPES: AD was defined according to criteria in line with Braak et al. 2 and Hyman et al. 3 Va. D was defined as clear vascular-ischemic pathology without significant neurodegenerative 4 changes. MD was defined as having a significant vascular component as well as a minimum Braak stage of III, thus the pathology of both vascular-ischemic and AD type considered severe enough to contribute to the clinical disease. Prevalence of DM among the Swedish population within a similar age group (>65 years) is 15, 6%. 5 ! RESULTS: From retrievable data – 74% of the Va. D cases and 37% of the AD cases had HT (p < 0. 001). HT among the cases with MD was 44%. RESULTS: From retrievable data - 31% of the Va. D cases and only 12% of the AD cases had DM (p = 0. 014), while 19% of the MD group had DM. COMMENTS AD and Va. D have markedly dissimilar pathology and the prevalence of HT and DM was markedly different between these groups. The finding that DM among our AD subjects was less frequent than in the Swedish population in general should be considered a strong indication that DM does not contribute to AD pathology. 1 Javanshiri et al, J Alz Dis. 2018. 2012. 4 Skrobot O et al, Brain 2016. 2 Braak H, Braak E, Acta Neuropathol 1991. 5 Andersson et al PLo. S ONE 2015 3 Hyman et al, Alz & Dem