Circle of Willis Atherosclerosis Is a Risk Factor for Sporadic Alzheimer’s Disease

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Abstract
Objectives— We conducted a quantitative investigation of brain arterial atherosclerotic damage and its relationship to sporadic Alzheimer’s disease (AD). Methods and Results— Fifty-four consecutive autopsy cases, 32 AD and 22 nondemented control subjects, were examined to establish the degree of arterial stenosis. Vessel external and lumenal area measurements were taken from 3-mm arterial cross-sections to calculate a stenosis index. AD patient circle of Willis arteries possessed a significant degree of stenosis as a consequence of multiple and severe atherosclerotic lesions. These lesions were significantly more severe in AD cases than in age-matched controls ( P R =0.67; P Conclusions— Our study reveals an association between severe circle of Willis atherosclerosis and sporadic AD that should be considered a risk factor for this dementia. These observations strongly suggest that atherosclerosis-induced brain hypoperfusion contributes to the clinical and pathological manifestations of AD.