Clinical Significance of Silent Cerebral Infarctions in Patients With Alzheimer Disease

다국어 초록 (Multilingual Abstract)

BACKGROUND: Although recent advances in the epidemiology of Alzheimer disease (AD) suggest a strong association between vascular factors predisposing to cerebrovascular disease and AD, the results of many studies on the relation between cerebrovascular disease and AD have been yet controversial. Therefore, we conducted this study to clarify the relation between concomitant silent cerebral infarctions and the cognitive decline of AD patients. METHODS: One hundred and fifty subjects participated in this study: 51 patients had AD, 44 patients had AD with silent cerebral infarction (ADI), and there were 45 control subjects. These subjects received the global cognitive function testing and they were all evaluated with detailed neuropsychologic tests including attention, memory, language, and also the visuospatial and frontal function. RESULTS: Compared with the control group, the patients with AD and ADI demonstrated significantly impairments in all cognitive domains. The ADI group showed more marked impairment than did the AD group on the domains including the language function, the delayed recall test, and semantic fluency. CONCLUSIONS: ADI showed more severe cognitive decline than AD, indicating that cerebrovascular disease contributes to the severity of cognitive decline. These results suggest that prevention of cerebrovascular disease can play an important role in preventing the rapid cognitive decline of AD.