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NCIRE-The Veterans Health Research Institute is the leading private nonprofit institute devoted to Veterans health research in the United States. Our mission is to advance Veterans health through research.

We support the work of some of the nation's foremost physicians and scientists at the San Francisco Veterans Affairs Medical Center, the premier biomedical research facility in the VA system. All have faculty appointments at the University of California, San Francisco, which has its own proud traditions of research and patient care. We also partner with the U.S. Department of Defense to support health research on behalf of our men and women in the Armed Forces.

Those who have served in uniform have given their best for their country. In return, we believe that they deserve nothing less than the best health care research we can provide.

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Joseph Rapp, MD

Staff Physician, Chief of Vascular Surgery Service, SFVAMC
Professor of Surgery, UCSF
Email: joseph.rapp@va.gov

Investigating Causes of Vascular Dementia

Vascular dementia is recognized as a common cause of intellectual deterioration in the elderly. While it can occur after stroke, it is also thought to occur as the result of lesions in the brain caused by hypertension. However, microemboli (tiny blood clots) in the brain, originating from the heart or carotid arteries, cause lesions similar to those occurring from hypertension. Microemboli frequently occur in the elderly population and Dr. Rapp hypothesizes that these are an unrecognized cause of vascular dementia. His research has shown that microemboli cause small breaks in the blood-brain barrier, initiate an inflammatory response in the brain, and start a potentially destructive immune response as well. These data suggest that imaging tests such as transcranial Doppler could be used to identify patients at risk for microembolization and to determine the need for aggressive preventive therapy.

To see Dr. Rapp on Pub Med, click here.