Differential Cognitive Decline in Alzheimer's Disease Is Predicted by Changes in Ventricular Size but Moderated by Apolipoprotein E and Pulse Pressure.
J Alzheimers Dis
; 85(2): 545-560, 2022.
Article
em En
| MEDLINE
| ID: mdl-34864669
ABSTRACT
BACKGROUND:
Differential cognitive trajectories in Alzheimer's disease (AD) may be predicted by biomarkers from multiple domains.OBJECTIVE:
In a longitudinal sample of AD and AD-related dementias patients (nâ=â312), we tested whether 1) change in brain morphometry (ventricular enlargement) predicts differential cognitive trajectories, 2) further risk is contributed by genetic (Apolipoprotein E [APOE] É4+) and vascular (pulse pressure [PP]) factors separately, and 3) the geneticâ+âvascular risk moderates this pattern.METHODS:
We applied a dynamic computational approach (parallel process models) to test both concurrent and change-related associations between predictor (ventricular size) and cognition (executive function [EF]/attention). We then tested these associations as stratified by APOE (É4-/É4+), PP (low/high), and APOE+ PP (low/intermediate/high) risk.RESULTS:
First, concurrently, higher ventricular size predicted lower EF/attention performance and, longitudinally, increasing ventricular size predicted steeper EF/attention decline. Second, concurrently, higher ventricular size predicted lower EF/attention performance selectively in APOEÉ4+ carriers, and longitudinally, increasing ventricular size predicted steeper EF/attention decline selectively in the low PP group. Third, ventricular size and EF/attention associations were absent in the high APOE+ PP risk group both concurrently and longitudinally.CONCLUSION:
As AD progresses, a threshold effect may be present in which ventricular enlargement in the context of exacerbated APOE+ PP risk does not produce further cognitive decline.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Apolipoproteínas E
/
Pressão Sanguínea
/
Encéfalo
/
Doença de Alzheimer
/
Disfunção Cognitiva
Tipo de estudo:
Clinical_trials
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
J Alzheimers Dis
Assunto da revista:
GERIATRIA
/
NEUROLOGIA
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Canadá