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COMMENTS AND OPINIONS
Stroke and Memory Decline: A Question of Degenerative or Vascular Origin—Reply
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In reply
We appreciate the comments by Dr Panza and colleagues regarding our article demonstrating a relation between stroke and memory decline.1 Several studies have shown an association between dementia and cognitive decline and cerebrovascular disease, defined either by history of a clinical stroke2 or identified by brain imaging.3 Cerebrovascular disease is a precursor to vascular dementia, but it is unclear what role cerebrovascular disease or its antecedents have in AD, which is characterized by the deposition of amyloid  .4 It is possible that cerebrovascular disease causes an amnestic syndrome that mimics AD through strategic infarcts, hippocampal sclerosis, or other mechanisms. Alternatively, vascular disease may be a more direct cause of AD or act as a comorbid condition accompanying diabetes, hypercholesterolemia, or other vascular risk factors, reducing the threshold at which symptoms develop. Our study could not address any of these mechanisms and simply underlines the importance of stroke in . . . [Full Text of this Article] AUTHOR INFORMATION
Christiane Reitz, MD;
José A. Luchsinger, MD;
Richard Mayeux, MD
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