Costantino Iadecola, MD: Awareness of Vascular Risk Factors in Alzheimer Disease

“In the sporadic cases [of Alzheimer], it is much more complex. I don’t think that the single approach is going to work. If you look at the brain of someone who died from sporadic Alzheimer disease, you’ll see 5 or 6 pathologies at the same time.”

The understanding of Alzheimer disease and its various pathologies has been a growing and shifting process in the last few decades. Despite failures in amyloid-beta targeted treatments in clinical trials, the knowledge of the disease’s pathways in the brain has allowed for physicians such as Costantino Iadecola, MD, to take on a different perspective in their approach.

Iadecola, who is the Ann Parish Titzell Professor of Neuroscience and director of the Feil Family Brain and Mind Research Institute at Weill Cornell Medicine, noted that in cases of familial Alzheimer disease, the approach required may be slightly more simple because the ability of therapies to clear amyloid can theoretically fix the disease, particularly now that modulators of key enzyme processes are being developed. In sporadic disease, however, a number of pathologies are often at play, requiring a more tailored and multifactorial approach.

In this interview with NeurologyLive, Iadecola offers his perspective on the current understanding of these approaches and what he believes needs to happen to increase the physician awareness of some of the vascular risk factors that can be at play in this disease, as well as the public health issue it brings to light.