Population studies of sporadic cerebral amyloid angiopathy and dementia: a systematic review

BMC Neurol. 2009 Jan 13;9:3. doi: 10.1186/1471-2377-9-3.

Abstract

Background: Deposition of amyloid-beta (Abeta) in vessel walls of the brain as cerebral amyloid angiopathy (CAA) could be a major factor in the pathogenesis of dementia. Here we investigate the relationship between dementia and the prevalence of CAA in older populations. We searched the literature for prospective population-based epidemiological clinicopathological studies, free of the biases of other sampling techniques, which were used as a comparison.

Methods: To identify population-based studies assessing CAA and dementia, a previous systematic review of population-based clinicopathological studies of ageing and dementia was employed. To identify selected-sample studies, PsychInfo (1806-April Week 3 2008), OVID MEDLINE (1950-April Week 2 2008) and Pubmed (searched 21 April 2008) databases were searched using the term "amyloid angiopathy". These databases were also employed to search for any population-based studies not included in the previous systematic review. Studies were included if they reported the prevalence of CAA relative to a dementia classification (clinical or neuropathological).

Results: Four population-based studies were identified. They showed that on average 55-59% of those with dementia displayed CAA (of any severity) compared to 28-38% of the non-demented. 37-43% of the demented displayed severe CAA in contrast to 7-24% of the non-demented. There was no overlap in the range of these averages and they were less variable and lower than those reported in 38 selected sample studies (demented v non-demented: 32-100 v 0-77% regardless of severity; 0-50 v 0-11% for severe only).

Conclusion: CAA prevalence in populations is consistently higher in the demented as compared to the non-demented. This supports a significant role for CAA in the pathogenesis of dementia.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review
  • Systematic Review

MeSH terms

  • Aged, 80 and over
  • Aging
  • Apolipoproteins E / genetics
  • Brain / pathology*
  • Cerebral Amyloid Angiopathy / complications
  • Cerebral Amyloid Angiopathy / epidemiology*
  • Cerebral Amyloid Angiopathy / pathology
  • Dementia / complications
  • Dementia / epidemiology*
  • Dementia / pathology
  • Female
  • Humans
  • Male
  • Prevalence
  • Risk Factors

Substances

  • Apolipoproteins E