Blood-brain barrier disturbance in patients with Alzheimer's disease is related to vascular factors

To investigate the blood-brain barrier (BBB function), serum and cerebrospinal fluid (CSF) from 118 patients with Alzheimer's disease (AD) and 50 healthy controls was analyzed with regard to albumin concentrations. For the AD group, clinical vascular factors were also recorded. The CSF/serum albumin ratio was used as a measure of BBB function. When compared with controls, the AD group showed a higher mean albumin ratio, indicating a decline in BBB function. However, no significant reduction in BBB function was found in AD patients without vascular factors. These findings support the hypothesis that BBB disturbance is related to vascular factors, coexisting with AD. In the control group, no significant correlation between age and albumin ratio was found, which suggests that aging per se is not primarily associated with a decline in BBB function. The present study provides evidence in favour of the conclusion that a reduced BBB function is related neither to AD nor to aging, but to clinical vascular factors.