Vascular biomarkers and ApoE4 expression in mild cognitive impairment and Alzheimer's disease
Diana C Oviedo1, Hector Lezcano2, Ambar R Perez1,3
1Universidad Católica Santa María La Antigua (USMA), Panamá.
Abstract:
Vascular pathology and genetic markers such as apolipoprotein E allele ε4 (ApoE ε4) are risk factors for the progression from mild cognitive impairment (MCI) to Alzheimer's disease (AD). In Panama, a high prevalence of vascular risk factors and an increase in the aging population, generate the need to investigate biomarkers using specific, sensitive, non-invasive and cost-efficient methods that could be used in primary care. The main objective of this study was to explore the association between vascular biomarkers such as intima-media thickness (IMT) and stenosis, ApoΕ ε4 and cognitive function in a sample of older adults, including healthy controls (n = 41), MCI (n = 33), and AD (n = 12). A descriptive and cross-sectional study was conducted. Participants were part of the Panama Aging Research Initiative (PARI), the first prospective study in aging in Panama. Assessments included a neuropsychological battery, ApoΕ ε4 genotyping and a Doppler ultrasound of the left carotid artery to examine the presence of vascular risk factors. Neuropsychological tests were combined to form six cognitive domains: Global cognition, language, visuospatial abilities, learning and memory, attention and executive functions. Multivariable analyses (using age, education, and ApoE ε4 expression as covariates) were conducted. Participants with increased IMT showed poorer performance in memory and those with carotid stenosis showed poorer performance in language, visuospatial abilities and attention, independent of age, education or ApoΕ ε4 expression. The results support the use of vascular markers in cognitive assessments of aged individuals.
Insights
Vascular health impacts cognition in older adults. Increased intima-media thickness and carotid stenosis are linked to poorer memory, language, and attention, supporting their use as biomarkers for cognitive decline.
Area of Science:
- Neurology
- Gerontology
- Cardiology
Background:
- Vascular pathology and apolipoprotein E allele ε4 (ApoE ε4) are known risk factors for Alzheimer's disease progression.
- Panama faces a growing aging population and high vascular risk, necessitating accessible biomarkers for early detection.
Purpose of the Study:
- To investigate the association between vascular biomarkers (intima-media thickness, carotid stenosis), ApoE ε4, and cognitive function in older adults.
- To explore the utility of non-invasive vascular assessments in primary care settings for cognitive health evaluation.
Main Methods:
- A descriptive, cross-sectional study of 86 participants (healthy, MCI, AD) from the Panama Aging Research Initiative (PARI).
- Assessments included neuropsychological testing across six cognitive domains, ApoE ε4 genotyping, and Doppler ultrasound of the carotid artery.
- Multivariable analyses controlled for age, education, and ApoE ε4 expression.
Main Results:
- Increased intima-media thickness was associated with poorer memory performance.
- Carotid stenosis correlated with deficits in language, visuospatial abilities, and attention.
- These associations were independent of age, education, and ApoE ε4 status.
Conclusions:
- Vascular markers like intima-media thickness and carotid stenosis show significant associations with cognitive function in older adults.
- These findings support the integration of vascular assessments into routine cognitive evaluations for early detection of impairment.
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