05 February 2020
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Research published in the Journal of Alzheimer’s disease has found that in patients with or at risk of Alzheimer’s disease, the combination of cerebrovascular disease and a protein called amyloid beta dramatically increases cognitive decline.

The study looked at better ways to diagnose the specific cause of dementia, by testing for multiple conditions. In most cases of dementia, there are multiple pathological changes in the brain.

Associate Professor Nawaf Yassi, The Royal Melbourne Hospital (RMH) Neurologist and joint laboratory head at the Walter and Eliza Hall Institute of Medical Research, said that while the primary change in Alzheimer’s disease is the accumulation of a protein known as amyloid beta (Aβ), damage to the blood vessels in the brain (cerebrovascular disease) is also very common in addition to this.

“Almost every patient has a combination of changes happening in their brain when they are diagnosed with dementia,” said A/Prof Yassi, lead author of the study.

“This study was trying to understand what some of those combinations are so that we can work out, firstly how this affects prognosis, and so we have a chance to develop effective, targeted treatments in the future,”

“Research is currently focussed on one pathway, not multiple, but in order to treat the disease better we need to target multiple pathways, similar to what happens in cancer therapy.”

The paper focussed on two pathways, Aβ and cerebrovascular disease, and found when both were found, patient’s memory and brain volume deteriorated much faster than when only one was present.

“This supports the argument that more often than not, there is more than one factor happening in the development of dementia, and that this combination of diseases in the brain is associated with worse outcomes for patients” A/Prof Yassi said.

Two-hundred and eighteen participants underwent an Aβ PET scans, MRI scans and cognitive assessment over the course of 18-month intervals over an eight year period. The participants were part of a long running research study, the Australian Imaging, Biomarker and Lifestyle Study (AIBL) of Ageing.

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