Article ; Online: Lewy body pathology modifies risk factors for cerebral amyloid angiopathy when comorbid with Alzheimer's disease pathology.
Alzheimer's & dementia : the journal of the Alzheimer's Association
2024 Volume 20, Issue 4, Page(s) 2564–2574
Abstract: Introduction: Cerebral amyloid angiopathy (CAA) often accompanies dementia-associated pathologies and is important in the context of anti-amyloid monoclonal therapies and risk of hemorrhage.: Methods: We conducted a retrospective neuropathology- ... ...
Abstract | Introduction: Cerebral amyloid angiopathy (CAA) often accompanies dementia-associated pathologies and is important in the context of anti-amyloid monoclonal therapies and risk of hemorrhage. Methods: We conducted a retrospective neuropathology-confirmed study of 2384 participants in the National Alzheimer Coordinating Center cohort (Alzheimer's disease [AD], n = 1175; Lewy body pathology [LBP], n = 316; and mixed AD and LBP [AD-LBP], n = 893). We used logistic regression to evaluate age, sex, education, APOE ε4, neuritic plaques, and neurofibrillary tangles (NFTs) in CAA risk. Results: APOE ε4 increased CAA risk in all three groups, while younger age and higher NFT stages increased risk in AD and AD-LBP. In AD-LBP, male sex and lower education were additional risk factors. The odds of APOE ε4 carrier homozygosity related to CAA was higher in LBP (25.69) and AD-LBP (9.50) than AD (3.17). Discussion: AD and LBPs modify risk factors for CAA and should be considered in reviewing the risk of CAA. Highlights: Lewy body pathology modifies risk factors for cerebral amyloid angiopathy (CAA) when present along with Alzheimer's disease (AD) neuropathology. In the context of anti-amyloid monoclonal therapies and their associated risks for hemorrhage, the risk of underlying CAA in mixed dementia with Lewy body pathology needs to be considered. |
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MeSH term(s) | Male ; Humans ; Alzheimer Disease/pathology ; Apolipoprotein E4/genetics ; Lewy Bodies/pathology ; Retrospective Studies ; Cerebral Amyloid Angiopathy/epidemiology ; Cerebral Amyloid Angiopathy/pathology ; Amyloid ; Risk Factors ; Hemorrhage ; Plaque, Amyloid/pathology |
Chemical Substances | Apolipoprotein E4 ; Amyloid |
Language | English |
Publishing date | 2024-02-14 |
Publishing country | United States |
Document type | Journal Article |
ZDB-ID | 2211627-8 |
ISSN | 1552-5279 ; 1552-5260 |
ISSN (online) | 1552-5279 |
ISSN | 1552-5260 |
DOI | 10.1002/alz.13704 |
Database | MEDical Literature Analysis and Retrieval System OnLINE |
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