Baseline Results: The Association Between Cardiovascular Risk and Preclinical Alzheimer's Disease Pathology (ASCEND)...

Area of Science:

• Neuroscience
• Cardiovascular Health
• Racial Health Disparities

Background:

• Alzheimer's Disease (AD) affects African Americans (AAs) at a higher rate than non-Hispanic White Americans (Whites).
• Poor vascular function, genetics, stress, and inflammation are hypothesized contributors to AD pathology, potentially disproportionately impacting AAs.

Purpose of the Study:

• To investigate racial differences in AD biomarkers within the cerebrospinal fluid (CSF).
• To examine the relationship between peripheral vascular dysfunction, cognition, and CSF AD biomarkers.
• To determine if these relationships vary by race in a high-risk cohort.

Main Methods:

• Enrolled 82 cognitively normal, middle-aged adults (≥45 years) of AA and White race with a parental history of AD.
• Collected cerebrospinal fluid (CSF) via lumbar puncture.
• Performed vascular ultrasound and cognitive testing.

Main Results:

• AAs exhibited poorer preclinical vascular health (higher SBP, MAP, arterial stiffness) but lower CSF tau burden than Whites.
• Race significantly modified the association between total tau, phospho-tau, and executive function (Trails B).
• Smaller variations in tau correlated with poorer cognition in AAs compared to Whites.

Conclusions:

• In a high-risk cohort, AAs presented with worse peripheral vascular health and cognition than Whites.
• Despite lower overall tau burden, race altered the tau-cognition relationship, indicating that subtle tau differences are linked to worse cognitive function in AAs.