The role of cerebrovascular disease when there is concomitant Alzheimer disease

Area of Science:

• Neurology
• Neuroimaging
• Gerontology

Background:

• Cerebrovascular pathologies (CVP) are common comorbidities with Alzheimer's disease (AD).
• CVP rarely occurs in isolation in older adults and likely supports dementia pathogenesis.
• Understanding CVP's role is crucial for comprehending cognitive impairment and dementia.

Purpose of the Study:

• To illustrate the role of CVP in dementia using neuroimaging biomarkers.
• To analyze the frequency of CVP in relation to Alzheimer's disease biomarkers.
• To investigate the contribution of CVP to neurodegeneration and cognitive impairment.

Main Methods:

• Utilized data from the population-based Mayo Clinic Study of Aging.
• Employed a novel metric to identify individuals with cerebrovascular imaging abnormalities (V+).
• Assessed the frequency of V+ and beta-amyloid positivity (A+) and their combinations (A-V-, A-V+, A+V-, A+V+).
• Measured hippocampal volume loss over time to assess neurodegeneration.

Main Results:

• Presented the frequency of individuals with and without cerebrovascular abnormalities (V-/V+) alongside beta-amyloid status (A-/A+).
• Demonstrated the contribution of CVP to neurodegeneration, evidenced by hippocampal volume loss in different A/V categories.
• Highlighted the association between CVP and cognitive impairment.

Conclusions:

• Cerebrovascular pathologies play a significant supporting role in the pathogenesis of dementia.
• Neuroimaging biomarkers are essential for illustrating CVP's contribution to cognitive decline.
• Future study designs should consider the interplay between CVP and AD pathology.