White matter hyperintensity on MRI and plasma Aß42/40 ratio additively increase the risk of cognitive impairment in hypertensive adults.
Alzheimers Dement
; 2024 Sep 04.
Article
en En
| MEDLINE
| ID: mdl-39229896
ABSTRACT
INTRODUCTION:
Dementia often involves comorbid Alzheimer's and vascular pathology, but their combined impact warrants additional study.METHODS:
We analyzed the Systolic Blood Pressure Intervention Trial and categorized white matter hyperintensity (WMH) volume into highest versus lowest/mid tertile and the amyloid beta (Aß)42/40 ratio into lowest versus mid/highest ratio tertile. Using these binary variables, we created four exposure categories (1) combined low risk, (2) Aß risk, (3) WMH risk, and (4) combined high risk.RESULTS:
In the cohort of 467 participants (mean age 69.7 ± 7.1, 41.8% female, 31.9% nonwhite or Hispanic) during 4.8 years of follow-up and across the four exposure categories the rates of cognitive impairment were 5.3%, 7.8%, 11.8%, and 22.6%. Compared to the combined low-risk category, the adjusted hazard ratio for cognitive impairment was 4.12 (95% confidence interval, 1.71 to 9.94) in the combined high-risk category.DISCUSSION:
This study emphasizes the potential impact of therapeutic approaches to dementia prevention that target both vascular and amyloid pathology. HIGHLIGHTS White matter hyperintensity (WMH) and plasma amyloid (Aß42/40) are additive risk factors for the development of cognitive impairment in the SPRINT MIND trial. Individuals in the high-risk categories of both WMH and Aß42/40 had a near fivefold increase in risk of cognitive impairment during 4.8 years of follow-up on average. These findings suggest that treatment strategies targeting both vascular health and amyloid burden warrant further research.
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Base de datos:
MEDLINE
Idioma:
En
Revista:
Alzheimer's & dementia
/
Alzheimers Dement
/
Alzheimers dememt
Año:
2024
Tipo del documento:
Article
País de afiliación:
Estados Unidos