The fundamental pathology in Alzheimer’s disease (AD) is neuronal dysfunction leading to cognitive impairment. The amyloid-β peptide (Aβ), derived from amyloid precursor protein, is one driver of AD, but how it leads to neuronal dysfunction is not established. In this Review, I discuss the complexity of AD and possible cause-and-effect relationships between Aβ and the vascular and hemostatic systems. AD can be considered a multifactorial syndrome with various contributing pathological mechanisms. Therefore, as is routinely done with cancer, it will be important to classify patients with respect to their disease signature so that specific pathologies, including vascular pathways, can be therapeutically targeted.

阿尔茨海默氏病（AD）的基本病理是导致认知障碍的神经元功能障碍。衍生自淀粉样蛋白前体蛋白的淀粉样蛋白-β肽（Aβ）是AD的一种驱动力，但如何导致神经元功能障碍尚无定论。在这篇综述中，我讨论了AD的复杂性以及Aβ与血管和止血系统之间可能的因果关系。AD可以被认为是具有多种病理机制的多因素综合症。因此，就像常规治疗癌症一样，根据患者的疾病特征对患者进行分类非常重要，这样可以针对性地治疗特定疾病，包括血管通路。