Contributions of amyloid beta and cerebral small vessel disease in clinical decline.
Alzheimers Dement
; 20(3): 1868-1880, 2024 03.
Article
em En
| MEDLINE
| ID: mdl-38146222
ABSTRACT
INTRODUCTION:
We assessed whether co-morbid small vessel disease (SVD) has clinical predictive value in preclinical or prodromal Alzheimer's disease.METHODS:
In 1090 non-demented participants (65.4 ± 10.7 years) SVD was assessed with magnetic resonance imaging and amyloid beta (Aß) with lumbar puncture and/or positron emission tomography scan (mean follow-up for cognitive function 3.1 ± 2.4 years).RESULTS:
Thirty-nine percent had neither Aß nor SVD (A-V-), 21% had SVD only (A-V+), 23% Aß only (A+V-), and 17% had both (A+V+). Pooled cohort linear mixed model analyses demonstrated that compared to A-V- (reference), A+V- had a faster rate of cognitive decline. Co-morbid SVD (A+V+) did not further increase rate of decline. Cox regression showed that dementia risk was modestly increased in A-V+ (hazard ratio [95% confidence interval 1.8 [1.0-3.2]) and most strongly in A+ groups. Also, mortality risk was increased in A+ groups.DISCUSSION:
In non-demented persons Aß was predictive of cognitive decline, dementia, and mortality. SVD modestly predicts dementia in A-, but did not increase deleterious effects in A+. HIGHLIGHTS Amyloid beta (Aß; A) was predictive for cognitive decline, dementia, and mortality. Small vessel disease (SVD) had no additional deleterious effects in A+. SVD modestly predicted dementia in A-. Aß should be assessed even when magnetic resonance imaging indicates vascular cognitive impairment.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Demência Vascular
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Transtornos Cognitivos
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Doença de Alzheimer
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Doenças de Pequenos Vasos Cerebrais
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Disfunção Cognitiva
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article