Cleveland Clinic researchers discover elevated risk of brain bleeds in Alzheimer's patients

Researchers at Cleveland Clinic have discovered that the presence of Lewy body pathology in Alzheimer's patients elevates their risk factors for certain adverse outcomes, specifically brain bleeds. The results of the study were published Feb. 14 in Alzheimer's & Dementia.

Lewy body pathology is an atypical accumulation of the alpha-synuclein and neurite proteins in the brain, which can lead to Lewy body dementia. When experts found Lewy body pathology present along with Alzheimer's disease, they discovered that the combination of the two put patients at greater risk. 

On top of that, their analysis of 2,300 brain autopsy records from patients who had either Alzheimer's disease, Lewy body dementia or both and found evidence of cerebral amyloid angiopathy — a disorder that causes brain bleeds — in 82% of patients who had both Alzheimer's and dementia.  

"Currently, commonly tested biomarkers of Alzheimer's do not enable the clinician to rule out co-pathologies that increase risk for cerebral amyloid angiopathy," said Jagan Pillai, MD, PhD, a neurologist at Cleveland Clinic's Lou Ruvo Center for Brain Health and lead author of the study, said in a press release. 

In patients who only had Alzheimer's disease, it was present in 78% of cases. A single diagnosis of Lewy body dementia had the least amount of cerebral amyloid angiopathy with evidence of it present in 41% of cases.

"These findings provide further clues about underlying pathologic processes and should be considered when assessing a patient for anti-amyloid therapies," Dr. Pillai said.

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