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Letters to the Editor
March 2001

Small Concomitant Cerebrovascular Lesions Are Not Important for Cognitive Decline in Severe Alzheimer Disease

Arch Neurol. 2001;58(3):520-521. doi:

In a series of 237 longitudinally followed-up autopsy cases of definite Alzheimer disease (AD) (36 with concomitant cerebral infarcts [volume <10 cm3]), Lee et al1 observed that patients with mixed AD and infarcts had significantly higher ages at death and considerably lower Braak stages than patients with histopathologically "pure" AD.

Whereas the rate of cognitive decline on the Mini-Mental State Examination (MMSE) and Dementia Rating Scale was not significantly different between the groups, in AD patients with infarcts, there was a trend for more severe clinical dementia as measured by the Dementia Rating Scale but no such trend for the MMSE. The authors conclude that concomitant small cerebral infarcts with a total volume of less than 10 cm3 do not significantly influence the overall rate of cognitive decline in patients with AD.