The ARCHIVES article by Lee et al1 suggests that the co-occurrence of cerebrovascular lesions in patients with Alzheimer disease (AD) does not influence cognitive performance or the disease's course. We wish to contribute personal data suggesting that concomitant cerebrovascular disease may affect motor function and behavior.
We examined 63 consecutive patients who had probable and possible AD with cerebrovascular disease of mild cognitive severity (mean ± SD Mini-Mental State Examination score, 21 ± 3; range, 18-27; Clinical Dementia Rating of 0.5 and 1, 27 and 36 patients, respectively; mean ± SD age, 77 ± 9 years; mean ± SD disease duration, 37 ± 25 months). Patients with cortical infarcts were not included in our study. The diagnosis of AD was made on the basis of a standardized multidimensional protocol including history, clinical examination, detailed neuropsychological testing, single-photon emission tomographic scan, and temporal lobe-oriented computed tomographic scan. The presence and severity of cortical, white matter, and deep subcortical lesions and of leukoaraiosis were assessed on computed tomographic film with a standardized visual rating scale.2
Frisoni GB, Geroldi C. Cerebrovascular Disease Affects Noncognitive Symptoms in Alzheimer Disease. Arch Neurol. 2001;58(11):1939-1940. doi: