アルツハイマー病は血管病としての治療すべきである（Ｐｒｏ）

Abstract

Elevated plasma homocysteine levels are associated with an increased risk of developing atherosclerotic vascular disorders such as stroke, but have also been implicated for neurodegenerative diseases including Alzheimer's disease (AD). Other studies have reported that hyperhomocysteinemia is associated with developing silent brain infarctions and white matter lesions in community-dwelling elderly people. It is not uncommon for such ischemic cerebrovascular lesions to be found in otherwise typical AD patients on magnetic resonance imaging. Such co-existing cerebrovascular diseases in AD must be important in developing aspiration pneumonia and falls. Previous studies demonstrated that basal ganglia infarcts, either silent or symptomatic, impaired swallowing function and these lesions were associated with an increased risk of developing aspiration pneumonia in AD patients, particularly in later stages. Further, periventricular white matter lesions are associated with an increased risk of falls irrespective of clinical stages of AD.