[p4–460]: Associations Between Vascular Risk Factors and Ad Biomarkers in Cognitively Normal Individuals
Year: 2017
Type: article
Study design: Observational Study
Abstract: Epidemiological studies have identified a number of predominantly vascular risk factors that increase the risk of progression to Alzheimer's disease (AD)-type dementia. It remains uncertain in which stage these factors have an influence and how they are associated with AD biomarkers. Therefore, we investigated how risk factors are associated with AD biomarkers in cerebrospinal fluid (CSF) and whether they influence cognitive decline in preclinical AD. We selected 438 participants from the longitudinal studies at the Knight Alzheimer's Disease Research Center (mean age: 68.3, SD: 8.5), with a baseline Clinical Dementia Rating (CDR) of 0. All participants had baseline data available for 12 risk factors (Table 1), neuropsychological testing, APOE genotyping and CSF levels of Ab 1–42, tau and p-tau181. We created four groups based on the abnormality of Ab (A +/-) and tau(s) (T +/-) and compared differences in frequency of risk factors among groups using Chi-Square testing. Cognitive decline, with MMSE as outcomes measure, was assessed using linear mixed modeling. All analyses were adjusted for demographics and APOE genotype. The frequencies of risk factors and baseline characteristics for each biomarker group are shown in Table 1. We found a higher frequency of transient ischemic attach (TIA) and a lower frequency of obesity in the T+ groups. Cardiovascular disorders occurred more frequently in the A+T+ group, compared to the A-T- group (Table 1). We found that in the A+T+ group, hypercholesterolemia and depression decreased the rate of decline, whereas hypertension increased this rate of decline (Figure 1). The other risk factors did not influence cognitive decline in the total sample, nor in the biomarker groups. We found that cardiovascular disorders are associated with preclinical AD. TIA and a lower body mass index are associated with neuronal injury. The protective effect of hypercholesterolemia and depression on cognitive decline in individuals with AD biomarkers, could result from previous or current medication use. Future studies with longitudinal biomarker data may provide more insight into the causal relationship between risk factors and AD pathology. The panels represent the mean scores and 95% confidence intervals of cognitive decline (MMSE scores) for the four biomarker groups and by presence of the risk factors. Panel A shows the effect of hypertension in the AT groups. Panel B shows the effect of hypercholesterolemia in the AT groups. Panel C shows the effect of depression in the AT groups.
Source: Alzheimer s & Dementia
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2766901403