The role of diabetes and vascular burden in Alzheimer’s disease: a pathophysiological perspective

From this thesis, it can be concluded that diabetes is not associated with AD pathophysiology and that diabetes and AD show independent and different patterns of cognitive functioning and decline. Vascular burden, especially cerebral microbleeds, are closely associated with AD but do not contribute to cognitive decline in a memory clinic setting. With this knowledge, diagnostics and prognostics can be improved in persons with diabetes and/or vascular burden. Moreover, findings underline the importance of preventing diabetes and controlling blood glucose. It also informs future clinical (drug) trials for AD, updates current theoretical frameworks, and shows the strength of pooling data. Future studies should further explore vascular contributions, their underlying pathways, and their role in AD or other types of dementia.