Influence of comorbidity of cerebrovascular disease and amyloid on Alzheimer's disease
Journal Title
Handbook of Prevention and Alzheimer's Disease
Publication Type
Book Chapter
Abstract
Background: Quantifying the contribution of cerebrovascular disease to the clinical and pathological profile of Alzheimer's disease is challenging. Objective: We aimed to determine the influence of cerebrovascular disease, amyloid-(A), and their comorbidity on cognitive decline, hippocampal atrophy, and A deposition, by evaluating data from the Australian Imaging, Biomarker and Lifestyle Study of Ageing. Methods: Two-hundred and eighteen participants underwent A PET, MRI, and cognitive assessment at 18-month intervals for up to 90 months. A status was determined on baseline PET. Participants were also classified as V+ on baseline MRI if they had≥1 large cortical infarcts, subcortical infarcts, or cortical cerebral microinfarcts; or white matter hyperintensity volume greater than the 90th percentile of healthy controls. Linear mixed models were conducted comparing slopes of change in cognition, hippocampal volume, and A load between the four resultant groups. Results: Mean age at baseline was 74 years (range 59-96). One-hundred and fifteen participants were cognitively normal, 54 had mild cognitive impairment, and 49 had Alzheimer's disease. Compared to the A-/V-group, the A+/V-and A+/V+ groups showed significantly faster cognitive decline and hippocampal atrophy over 90 months. V+ status was associated with greater cognitive decline (Cohen's d = 0.85, p < 0.001) and hippocampal atrophy (d = 2.05, p < 0.001) in the A+ group but not in the A-group. V+ status was not associated with A accumulation in any group. Conclusion: Comorbidity of cerebrovascular disease and A was associated with cognitive decline and neurodegeneration. Cerebrovascular disease was not associated with the rate of A accumulation. © 2024 IOS Press. All rights reserved.
Publisher
IOS Press
Research Division(s)
Population Health And Immunity
Terms of Use/Rights Notice
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Creation Date: 2024-04-18 09:15:22
Last Modified: 2024-04-18 09:26:05
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