Vascular disease and risk factors are associated with cognitive decline in the alzheimer disease spectrum.
Vascular disease and risk factors are associated with cognitive decline in the alzheimer disease spectrum.
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DOI：
10.1097/wad.0000000000000043
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发表时间：
2015-01
影响因子：
2.1
通讯作者：
Alzheimer’s Disease Neuroimaging Initiative
中科院分区：
文献类型：
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作者：
Lorius N;Locascio JJ;Rentz DM;Johnson KA;Sperling RA;Viswanathan A;Marshall GA;Alzheimer’s Disease Neuroimaging Initiative
我们调查了血管疾病和危险因素与正常老年人对照（NC）、轻度认知障碍（MCI）和轻度阿尔茨海默病（AD）痴呆受试者认知能力下降之间的横断面和纵向关系。812名参与者（229名NC， 395名MCI， 188名AD）在基线和3年内接受了认知测试、脑磁共振成像和临床评估。采用一般线性、纵向混合效应和Cox比例风险模型。高同型半胱氨酸水平和白质高强度（WMH）体积与处理速度损伤相关（同型半胱氨酸：p=0.02; WMH: p<0.0001）；血管指数评分较高与记忆障碍相关（p=0.007）；载脂蛋白E ε4 （APOE4）等位基因数量较多与整体认知功能障碍相关（p=0.007）。随着时间的推移，APOE4与整体认知障碍（p=0.002）和处理速度障碍（p=0.001）的增加率较高相关，而高总胆固醇与整体认知障碍（p=0.02）和记忆障碍（p=0.06）的增加率较高相关。这些结果表明，在基线时血管负荷较低的样本中，随着时间的推移，AD谱系中血管疾病和危险因素的增加与认知障碍有显著的关联。
We investigated the relationship between vascular disease and risk factors versus cognitive decline cross-sectionally and longitudinally in normal older control (NC), mild cognitive impairment (MCI), and mild Alzheimer’s disease (AD) dementia subjects. 812 participants (229 NC, 395 MCI, 188 AD) underwent cognitive testing, brain magnetic resonance imaging, and clinical evaluations at baseline and over a period of 3 years. General linear, longitudinal mixed effects, and Cox proportional hazards models were used. Greater homocysteine level and white matter hyperintensity (WMH) volume were associated with processing speed impairment (homocysteine: p=0.02; WMH: p<0.0001); greater vascular index score was associated with memory impairment (p=0.007); and greater number of apolipoprotein E ε4 (APOE4) alleles was associated with global cognitive impairment (p=0.007) at baseline. APOE4 was associated with greater rate of increase in global cognitive impairment (p=0.002) and processing speed impairment (p=0.001) over time, while higher total cholesterol was associated with greater rate of increase in global cognitive impairment (p=0.02) and memory impairment (p=0.06) over time. These results suggest a significant association of increased vascular disease and risk factors with cognitive impairment at baseline and over time in the AD spectrum in a sample that was selected to have low vascular burden at baseline.