Article ; Online: Association of β-Amyloid and Vascular Risk on Longitudinal Patterns of Brain Atrophy.
2022 Volume 99, Issue 3, Page(s) e270–e280
Abstract: Background and objectives: Vascular risk factors and elevated β-amyloid (Aβ) are commonly observed together among older adults. Here, we examined the interactive vs independent effects of systemic vascular risk and Aβ burden on longitudinal gray matter ... ...
Abstract | Background and objectives: Vascular risk factors and elevated β-amyloid (Aβ) are commonly observed together among older adults. Here, we examined the interactive vs independent effects of systemic vascular risk and Aβ burden on longitudinal gray matter atrophy and how their co-occurrence may be related to cognitive decline in a cohort of clinically normal adults. A secondary goal was to examine whether vascular risk influences gray matter atrophy independently from markers of white matter injury. Methods: Participants were 196 adults (age 73.8 ± 6.1 years) from the Harvard Aging Brain Study. Baseline Aβ burden was quantified with Pittsburgh compound B PET. Baseline vascular risk was measured with the Framingham Heart Study cardiovascular disease risk score. Brain atrophy was quantified longitudinally with structural MRI over a median of 4.50 (±1.26) years. Cognition was assessed yearly with the Preclinical Alzheimer Cognitive Composite over a median of 6.25 (±1.40) years. Linear mixed-effects models examined vascular risk and Aβ burden as interactive vs independent predictors of gray matter atrophy, with adjustment for age, sex, years of education, Results: Higher vascular risk and elevated Aβ burden interacted to predict more severe atrophy in frontal and temporal lobes, thalamus, and striatum. Higher Aβ burden, but not vascular risk, was associated with more severe atrophy in parietal and occipital lobes, as well as the hippocampus. Adjusting for diffusion- and FLAIR-based markers of white matter injury had little impact on the above associations. Gray matter atrophy mediated the association between vascular risk and cognitive decline at higher levels of Aβ burden. Discussion: We observed an interaction between elevated vascular risk and higher Aβ burden with longitudinal brain atrophy, which in turn influenced cognitive decline. These results support vascular risk factor management as a potential intervention to slow neurodegeneration and cognitive decline in preclinical Alzheimer disease. |
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MeSH term(s) | Humans ; Aged ; Amyloid beta-Peptides/metabolism ; Brain/pathology ; Alzheimer Disease/pathology ; Gray Matter/pathology ; Cognitive Dysfunction/diagnostic imaging ; Cognitive Dysfunction/pathology ; Longitudinal Studies ; Magnetic Resonance Imaging ; Atrophy/pathology ; Positron-Emission Tomography |
Chemical Substances | Amyloid beta-Peptides |
Language | English |
Publishing date | 2022-07-18 |
Publishing country | United States |
Document type | Journal Article |
ZDB-ID | 207147-2 |
ISSN | 1526-632X ; 0028-3878 |
ISSN (online) | 1526-632X |
ISSN | 0028-3878 |
DOI | 10.1212/WNL.0000000000200551 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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