The role of cerebral blood flow in the pathogenesis of Alzheimer's Disease Dementia

Accounting for approximately 70 % of dementia cases and rising globally, Alzheimer's Disease Dementia (ADD) is a formidable challenge to patients, carers and healthcare professionals worldwide. ADD has a significant impact on patient's and carers’ quality of life, as well as substantial economical and societal costs. Therefore, understanding the pathogenesis of ADD to identify potential treatment targets is becoming an important research priority. For several decades, the amyloid cascade hypothesis has dominated ADD research, however recent critiques have called this into question. Research suggests there may be a significant vascular component, which may occur earlier, potentiate, and drive further amyloid pathology in the brain. One potential area for further exploration is the role of vascular dysregulation in the pathogenesis of ADD. In this review, we examine the current literature regarding vascular dysregulation, and its role in the development of ADD. We further explore the complexity involved in the intersection between vascular insults and the amyloid-cascade hypothesis, and call for further research in the use of cerebral blood flow for a diagnostic and therapeutic target for ADD.