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Amyloid, Vascular, and Resilience Pathways Associated with Cognitive Aging.
Vemuri, Prashanthi; Lesnick, Timothy G; Knopman, David S; Przybelski, Scott A; Reid, Robert I; Mielke, Michelle M; Graff-Radford, Jonathan; Lowe, Val J; Machulda, Mary M; Petersen, Ronald C; Jack, Clifford R.
Afiliação
  • Vemuri P; Department of Radiology, Mayo Clinic, Rochester, MN.
  • Lesnick TG; Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
  • Knopman DS; Department of Neurology, Mayo Clinic, Rochester, MN.
  • Przybelski SA; Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
  • Reid RI; Department of Information Technology, Mayo Clinic, Rochester, MN.
  • Mielke MM; Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
  • Graff-Radford J; Department of Neurology, Mayo Clinic, Rochester, MN.
  • Lowe VJ; Department of Neurology, Mayo Clinic, Rochester, MN.
  • Machulda MM; Department of Radiology, Mayo Clinic, Rochester, MN.
  • Petersen RC; Department of Psychiatry/Psychology, Mayo Clinic, Rochester, MN.
  • Jack CR; Department of Neurology, Mayo Clinic, Rochester, MN.
Ann Neurol ; 86(6): 866-877, 2019 12.
Article em En | MEDLINE | ID: mdl-31509621
OBJECTIVE: To investigate the multifactorial processes underlying cognitive aging based on the hypothesis that multiple causal pathways and mechanisms (amyloid, vascular, and resilience) influence longitudinal cognitive decline in each individual through worsening brain health. METHODS: We identified 1,230 elderly subjects (aged ≥50 years) with an average of 4.9 years of clinical follow-up and with amyloid positron emission tomography, diffusion tensor imaging, and structural magnetic resonance imaging scans from the population-based Mayo Clinic Study of Aging. We examined imaging markers of amyloid and brain health (white matter microstructural integrity and cortical thinning), systemic vascular health preceding the imaging markers, and early to midlife intellectual enrichment to predict longitudinal cognitive trajectories. We used latent growth curve models for modeling longitudinal cognitive decline. RESULTS: All the pathways (amyloid, vascular, resilience) converged through their effects on cortical thinning and worsening cognition and together explained patterns in cognitive decline. Resilience and vascular pathways (aging process, sex differences, education/occupation, and systemic vascular health) had significant impact on white matter microstructural integrity. Education/occupation levels contributed to white matter integrity through systemic vascular health. Worsening white matter integrity contributed to significant cortical thinning and subsequently longitudinal cognitive decline. Baseline amyloidosis contributed to a significant proportion of cognitive decline that accelerated with longer follow-up times, and its primary impact was through cortical thinning. INTERPRETATION: We developed an integrated framework to help explain the dynamic and complex process of cognitive aging by considering key causal pathways. Such an approach is important for both better comprehension of cognitive aging processes and will aid in the development of successful intervention strategies. ANN NEUROL 2019;86:866-877.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Circulação Cerebrovascular / Angiopatia Amiloide Cerebral / Tomografia por Emissão de Pósitrons / Imagem de Tensor de Difusão / Disfunção Cognitiva / Envelhecimento Cognitivo Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Circulação Cerebrovascular / Angiopatia Amiloide Cerebral / Tomografia por Emissão de Pósitrons / Imagem de Tensor de Difusão / Disfunção Cognitiva / Envelhecimento Cognitivo Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: En Ano de publicação: 2019 Tipo de documento: Article