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Updated: May 18, 2026
09:17
Using Retinal Imaging to Study Dementia
Published on: November 6, 2017
Vascular burden and Alzheimer disease pathologic progression.
Raymond Y Lo1, William J Jagust,
1Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA, USA. rayyenyu@hotmail.com
Neurology
|September 14, 2012
Summary
Vascular factors like white matter hyperintensities (WMHs) impact cognitive decline and brain metabolism but do not directly alter Alzheimer disease (AD) biomarker progression. This suggests vascular dementia is additive to AD pathology.
Area of Science:
- Neuroscience
- Neurology
- Gerontology
Background:
- Alzheimer disease (AD) is a neurodegenerative disorder characterized by specific biomarkers.
- Vascular contributions to cognitive impairment and dementia (VCID) are increasingly recognized.
- The interplay between vascular burden and AD pathology requires further investigation.
Purpose of the Study:
- To investigate the vascular contribution to longitudinal changes in Alzheimer disease (AD) biomarkers.
- To assess whether vascular burden modifies the rate of change in AD biomarkers over time.
- To explore the relationship between vascular risk factors, white matter hyperintensities (WMHs), and cognitive decline.
Main Methods:
- Utilized data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) longitudinal study.
- Measured cerebrospinal fluid (CSF), Positron Emission Tomography (PET), and Magnetic Resonance Imaging (MRI) biomarkers.
- Employed generalized estimating equations to model the association between vascular burden (risk scores, WMHs) and biomarker changes, including interactions with time.
Main Results:
- Cardiovascular risk profiles did not predict progression in CSF β₄₂-amyloid, FDG PET uptake, or hippocampal atrophy.
- Greater baseline cardiovascular risks and WMHs were associated with cognitive impairment, especially executive function deficits.
- Increased WMHs over time correlated with faster executive function decline and reduced glucose metabolism in normal cognition (NC) participants, but not with AD biomarkers.
Conclusions:
- Increased WMHs are linked to aging, reduced brain metabolism, and executive function decline.
- WMHs do not appear to influence the progression of AD-specific pathological biomarkers.
- The vascular contribution to dementia likely acts additively to, but not necessarily independently of, the amyloid pathway.
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