| Carotid artery ultrasound and echocardiography testing to lower the prevalence of Alzheimer's disease. | |
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MedLine Citation:
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PMID: 19560690 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The use of two clinic office techniques, carotid artery ultrasound and echocardiography (CAUSE), to detect deficient brain blood flow delivery in the healthy, cognitively normal, older individual is proposed. Evidence indicates that persistent heart-to-brain blood flow deficit involving low cardiac output or low ejection fraction and carotid artery narrowing can promote cognitive impairment and that such impairment may lead to Alzheimer's disease (AD) or vascular dementia (VaD). A number of independent epidemiologic studies reported cardiovascular and cerebrovascular disease to be risk factors to AD and VaD. The clinical rationale for CAUSE is to detect and prevent progression of cognitive dysfunction in elderly persons and is based on the general understanding that mild cognitive impairment is a preclinical threshold to AD or VaD with high conversion rates to either dementia. The use of CAUSE is anticipated to prevent or attenuate, by appropriate clinical management, mild cognitive impairment arising from persistent brain hypoperfusion, a condition implicated in the promotion of cognitive impairment in the elderly and a common preclinical feature seen in AD and VaD. As detection of lowered cerebral perfusion from cardiac and carotid artery pathology is achieved using these cost-effective, noninvasive, and relatively accurate ultrasound procedures, a significant reduction in the number of new AD and VaD cases would be anticipated after appropriate patient treatment. In this context, a brief summary is presented outlining recent medical and surgical treatments that may improve cerebral blood flow insufficiency. The merit of CAUSE in screening and treating mentally healthy elderly persons who are identified as being at risk of cognitive decline is that it could blunt the soaring socioeconomic impact that will hammer the health care system of many nations by the mounting dementia prevalence rate expected in the next 25 years. A 5- year delay in the onset of AD could reduce the prevalence of AD by 50%. We are making preparations to test the merit of CAUSE in a clinical study of a cognitively healthy elderly population. |
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Authors:
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Jack C de la Torre |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association Volume: 18 ISSN: 1532-8511 ISO Abbreviation: J Stroke Cerebrovasc Dis Publication Date: 2009 Jul-Aug |
Date Detail:
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Created Date: 2009-06-29 Completed Date: 2009-09-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9111633 Medline TA: J Stroke Cerebrovasc Dis Country: United States |
Other Details:
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Languages: eng Pagination: 319-28 Citation Subset: IM |
Affiliation:
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Center for Alzheimer's Research, Sun Health Research Institute, Sun City, Arizona 85351, USA. jcdelatorre@comcast.net |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Alzheimer Disease
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etiology*,
physiopathology,
prevention & control Carotid Stenosis / complications*, physiopathology, ultrasonography* Cerebrovascular Disorders / etiology, physiopathology, prevention & control Cognition Disorders / etiology*, physiopathology, prevention & control Dementia, Vascular / etiology, physiopathology, prevention & control Echocardiography / standards*, statistics & numerical data Heart Diseases / complications*, physiopathology, ultrasonography* Humans Prevalence Ultrasonography / standards*, statistics & numerical data |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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