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A neurodegenerative vascular burden index and the impact on cognition

Sebastian Heinzel1, Inga Liepelt-Scarfone2, Benjamin Roeben1

  • 1Department of Neurodegeneration, Hertie Institute for Clinical Brain Research (HIH), University of Tübingen , Tübingen , Germany.

Frontiers in Aging Neuroscience
|July 30, 2014
PubMed

Insights

A new vascular burden index (VBI) based on carotid intima-media thickness (IMT) can identify individuals with increased vascular risk factors. This index is linked to reduced cognitive function, suggesting potential for early detection of neurodegenerative processes.

Area of Science:

  • Neuroscience
  • Cardiology
  • Gerontology

Background:

  • Vascular burden factors impact vascular structure and function, measurable by carotid intima-media thickness (IMT).
  • A multifactorial vascular burden index (VBI) may correlate with early Alzheimer's disease (AD) pathology and preclinical cognitive decline.
  • Identifying individuals at risk for neurodegeneration is crucial for early intervention.

Purpose of the Study:

  • To investigate the multifactorial influence of vascular burden factors on IMT in an elderly cohort at risk for neurodegeneration.
  • To develop and validate a Vascular Burden Index (VBI) based on IMT and its associated risk factors.
  • To assess the impact of the VBI on cognitive performance in preclinical stages of cognitive decline.

Main Methods:

  • A cohort of 1102 elderly individuals at risk for neurodegeneration (TREND study) was analyzed.
  • Vascular factors (obesity, hypertension, smoking, diabetes, atherosclerosis) were selected based on statistical effects on IMT.
  • The VBI's impact on cognitive function was evaluated using the Trail-Making Test (TMT) and CERAD neuropsychological battery.

Main Results:

  • IMT was significantly predicted by age, sex, obesity, hypertension, smoking, diabetes, and atherosclerosis.
  • Individuals with two or more VBI factors had a 3.17 odds ratio for overly increased IMT (≥1.0 mm).
  • The VBI significantly impacted executive control and showed a trend toward decreased global cognitive function, independent of age, sex, and education.

Conclusions:

  • A VBI derived from IMT can identify individuals with increased vascular burden associated with cognitive decline.
  • This VBI may serve as a prodromal marker for neurodegenerative processes and cognitive decline in preclinical Alzheimer's disease.
  • Longitudinal studies are needed to confirm the VBI's value in predicting cognitive decline and AD progression.

Keywords:
Alzheimer’s diseaseCERAD neuropsychological batteryTübinger evaluation of risk factors for early detection of neurodegeneration (TREND) studycarotid intima-media thicknessneurodegenerationprodromal markertrail-making testvascular burden

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