The Molecular Genetics of the Risk Factors of Vascular Dementias*

Abstract

Secondary prevention of the age-associated dementias requires clarification of the risk factors. Vascular dementia is mainly due to cerebral hypoxic or hemorrhagic infarcts as a consequence of cerebrovascular disease. For this reason attention must be paid to the risk factors of cerebrovascular diseases. Both environmental and genetic causes determine the manifestation of these risk factors, for example, factors related to cholesterol and glucose metabolism, regulation of blood pressure and inflammatory cascades. Disturbances of genetically driven processes increase the risk of a cerebrovascular event. In this respect candidate genes and their polymorphisms need to be considered. In contrast to Alzheimer's disease, relevant molecular genetic investigations into vascular dementia are rare. For this reason research findings related to stroke and neurodegenerative dementias need to be extended and discussed with regard to their relevance in vascular dementia. Primary prevention of vascular dementia is not possible at present; secondary prevention, using both medicinal therapy and lifestyle modifications, can counteract susceptibility to the risks.