Association of vascular brain injury, neurodegeneration, amyloid, and cognitive trajectory
Association of vascular brain injury, neurodegeneration, amyloid, and cognitive trajectory
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DOI：
10.1212/wnl.0000000000010531
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发表时间：
2020-11-10
期刊：
影响因子：
9.9
通讯作者：
DeCarli, Charles
中科院分区：
文献类型：
--
作者：
Han, Ji Won;Maillard, Pauline;DeCarli, Charles
目的确定血管和神经退行性因素是否影响临床相关阿尔茨海默病病理学之前的认知，我们分析了60岁以上认知正常个体的种族多样性队列的MRI测量和淀粉样蛋白成像。（n = 154;平均年龄74.15 ± 6.94; 50%为女性; 54%白人，22.1%西班牙裔，14.9%非裔美国人）从加州大学戴维斯阿尔茨海默病研究中心招募，他们在基线、PET和MRI时认知正常，并接受了6.23 +/-4.16年的年度认知评估。混合模型回归随机斜率和截距计算情节记忆和执行功能，调整年龄，性别，教育，和ethnication.ResultsVascular负担评分与总白色物质高信号（WMH）体积（β，0.171; 95%置信区间[CI]，0.024-0.318）。WMH体积与低基线执行功能（-0.115; -0.226至-0.003）和记忆变化率（-0.029; -0.045至-0.012）相关。海马体积与记忆（0.040; 0.021-0.059）和执行功能（0.024; 0.008-0.039）的变化率相关。淀粉样蛋白状态的连续测量影响记忆的变化（-0.026; -0.044至-0.008）和执行功能（-0.033;结论血管性脑损伤和神经退行性变与基线认知能力和独立于淀粉样蛋白状态的纵向变化率相关，种族多样的认知正常个体，支持血管疾病作为老年痴呆症风险因素的作用。
ObjectiveTo determine whether vascular and neurodegenerative factors influence cognition before clinically relevant Alzheimer disease pathology, we analyzed MRI measures and amyloid imaging in an ethnoracially diverse cohort of cognitively normal individuals older than 60 years.MethodsParticipants (n = 154; mean age 74.15 +/- 6.94; 50% female; 54% Caucasian, 22.1% Hispanic, 14.9% African American) were recruited from the University of California, Davis Alzheimer's Disease Research Center, who were cognitively normal at baseline, time of PET, and MRI, and received yearly cognitive assessment for 6.23 +/- 4.16 years. Mixed model regression with random slope and intercept was calculated for episodic memory and executive function, adjusting for age, sex, education, and ethnicity.ResultsVascular burden score was associated with total white matter hyperintensity (WMH) volume (beta, 0.171; 95% confidence interval [CI], 0.024-0.318). WMH volume was associated with low baseline executive function (-0.115; -0.226 to -0.003) and rate of change in memory (-0.029; -0.045 to -0.012). Hippocampal volume was associated with the rate of change in memory (0.040; 0.021-0.059) and executive function (0.024; 0.008-0.039). Continuous measures of amyloid status influenced change in memory (-0.026; -0.044 to -0.008) and executive function (-0.033; -0.046 to -0.021) independently of MRI measures.ConclusionVascular brain injury and neurodegeneration are associated with baseline cognitive performance and the rate of longitudinal change independent of amyloid status among community-dwelling, ethnicity diverse cognitively normal individuals, supporting the role of vascular diseases as risk factors for later-life dementia.