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Vascular risk, gait, behavioral, and plasma indicators of VCID
Sheelakumari Raghavan1, Scott A Przybelski2, Timothy G Lesnick2
1Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA.
Insights
Non-imaging indicators can predict white matter damage in vascular contributions to cognitive impairment and dementia (VCID). Their predictive value varies by age, with vascular risk and gait important for early changes, and plasma markers for later changes.
Area of Science:
- Neurology
- Neuroimaging
- Gerontology
Background:
- Vascular contributions to cognitive impairment and dementia (VCID) pose a significant public health challenge.
- Cost-effective screening tools for VCID are crucial for early detection and intervention.
- Magnetic resonance imaging (MRI) is a key tool for assessing white matter (WM) damage in VCID.
Purpose of the Study:
- To evaluate non-imaging indicators for predicting MRI-measured white matter (WM) damage in VCID.
- To determine if the association between non-imaging indicators and WM damage differs across age groups.
Main Methods:
- Utilized data from 745 participants (≥50 years) in the Mayo Clinic Study of Aging.
- Assessed serial WM damage using diffusion MRI and FLAIR-MRI.
- Examined associations between baseline non-imaging indicators (demographics, vascular risk factors [VRFs], gait, behavioral, plasma GFAP, plasma NfL) and WM damage across age tertiles.
Main Results:
- Vascular risk factors (VRFs) and gait were associated with diffusion MRI-measured WM changes across all age groups.
- Plasma glial fibrillary acidic protein (GFAP) and plasma neurofilament light chain (NfL) were associated with white matter hyperintensities (WMHs) primarily in intermediate and older age groups.
- Most non-imaging indicators explained WMH variability in intermediate and older age groups.
Conclusions:
- Non-imaging indicators effectively predict MRI-assessed WM damage in VCID.
- The predictive utility of these indicators is age-dependent.
- A framework for evaluating novel non-imaging VCID indicators is proposed.
Introduction:
Cost-effective screening tools for vascular contributions to cognitive impairment and dementia (VCID) has significant implications. We evaluated non-imaging indicators of VCID using magnetic resonance imaging (MRI)-measured white matter (WM) damage and hypothesized that these indicators differ based on age.
Methods:
In 745 participants from the Mayo Clinic Study of Aging (≥50 years of age) with serial WM assessments from diffusion MRI and fluid-attenuated inversion recovery (FLAIR)-MRI, we examined associations between baseline non-imaging indicators (demographics, vascular risk factors [VRFs], gait, behavioral, plasma glial fibrillary acidic protein [GFAP], and plasma neurofilament light chain [NfL]) and WM damage across three age tertiles.
Results:
VRFs and gait were associated with diffusion changes even in low age strata. All measures (VRFs, gait, behavioral, plasma GFAP, plasma NfL) were associated with white matter hyperintensities (WMHs) but mainly in intermediate and high age strata.
Discussion:
Non-imaging indicators of VCID were related to WM damage and may aid in screening participants and assessing outcomes for VCID.
Highlights:
Non-imaging indicators of VCID can aid in prediction of MRI-measured WM damage but their importance differed by age. Vascular risk and gait measures were associated with early VCID changes measured using diffusion MRI. Plasma markers explained variability in WMH across age strata. Most non-imaging measures explained variability in WMH and vascular WM scores in intermediate and older age groups. The framework developed here can be used to evaluate new non-imaging VCID indicators proposed in the future.
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