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Posted: April 15, 2008

Experts Tie Hypertension, Diabetes to Dementia

Researchers think hypertension and diabetes may be among the leading causes of dementia because of the damage both conditions trigger in small blood vessels.
As a result, experts led by Dr. Thomas Montine of the University of Washington, are urging that their medical colleagues step up efforts to control high blood pressure, a condition found in one of every three adult Americans, and diabetes, which is estimated to affect more than 7% of the US population, or more than 22 million people. Montine made the plea as part of a presentation at an experimental biology conference in San Diego.
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The linkage was drawn in research conducted over 12 years on autopsied brains, which indicated that a third of men and women with dementia or cognitive decline showed evidence of small vessel damage. This vessel damage typically occurs in a cumulative action and can result from repeated mini strokes caused by hypertension and diabetes. These strokes are often so minor that they become apparent to an individual only after the cumulative effect reaches what researchers referred to as a critical mass.
Montine said the findings about damage to small blood vessels runs counter to conventional wisdom and other conclusions drawn from previous brain autopsy studies. He said he thinks he difference is based, at least in part, in the fact that his research was conducted in the broad population, while the previous autopsy studies generally were centered on Alzheimer’s treatment centers or were limited to one gender, ethnic or professional group.
Among other findings reported by Montine: 45% of the risk for dementia was tied to pathologic changes of Alzheimer's, while 10% was associated with Lewy bodies, which result in a degenerative brain disease called Lewy Body Dementia caused by neocortical structural changes.
The research outlined by Montine examined individuals who were part of a large managed care program representative of the metropolitan Seattle area they came from. They were white, Asian, African-American and Hispanic, and had a range of educational and professional backgrounds. The study ran between 1994 and 2006 and involved 3,400 participants, of whom 221 gave permission for autopsies which were used in the research.

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