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Alzheimer's Disease and Cognitive Decline in Patients with Cardiovascular Diseases Along the Heart-Brain Axis
Calvin Trieu1,2,3, Argonde C van Harten1,2, Anna E Leeuwis1,2
1Alzheimer Center Amsterdam, Neurology, Vrije Universiteit Amsterdam, Amsterdam University Medical Center (Amsterdam UMC), Amsterdam, The Netherlands.
Insights
Alzheimer's disease (AD) biomarkers in blood, including phosphorylated-tau181 (pTau181) and glial fibrillary acidic protein (GFAP), predict cognitive decline in individuals with cardiovascular diseases. These findings highlight the link between AD pathology and cognitive impairment in this population.
Area of Science:
- Neurology
- Cardiology
- Biomarker Research
Background:
- Cardiovascular diseases (CVD) are linked to cognitive decline.
- Alzheimer's disease (AD) pathology may exacerbate cognitive impairment in CVD patients.
- Investigating blood-based biomarkers for AD pathology in CVD is crucial.
Purpose of the Study:
- To examine the association between blood-based Alzheimer's disease (AD) biomarkers and cognitive decline.
- To assess biomarkers of astrocyte activation and neurodegeneration in relation to cognitive function.
- To determine if AD pathology accelerates cognitive decline in patients with cardiovascular diseases.
Main Methods:
- 412 patients with cardiovascular diseases and 128 controls were analyzed.
- Blood biomarkers including amyloid-β42/40, pTau181, GFAP, and NfL were measured.
- Cognitive functions were assessed over a 2.1-year follow-up period using linear mixed models.
Main Results:
- Lower amyloid-β42/40 was linked to faster global cognitive decline.
- Higher pTau181, GFAP, and NfL were associated with worse baseline cognitive performance and/or steeper decline across various domains.
- No significant associations were found in reference participants.
Conclusions:
- Blood-based biomarkers of AD pathology can predict cognitive decline in patients with cardiovascular diseases.
- GFAP and pTau181 are significant predictors of cognitive decline in this population.
- These findings underscore the importance of monitoring AD biomarkers in individuals with cardiovascular conditions.
Background:
We hypothesize that Alzheimer's disease (AD)-related pathology may accelerate cognitive decline in patients with cardiovascular diseases.
Objective:
To investigate the association between blood-based biomarkers of AD, astrocyte activation, and neurodegeneration and cognitive decline.
Methods:
From the multi-center Heart-Brain study, we included 412 patients with heart failure, carotid occlusive disease or vascular cognitive impairment (age:68.6±9.0) and 128 reference participants (65.7±7.5). Baseline amyloid-β42/40 (Aβ42/40), phosphorylated-tau181 (pTau181), glial fibrillary acidic protein (GFAP), and neurofilament light (NfL) were determined using SiMoA (Quanterix). Memory, attention, language, and executive functioning were evaluated (follow-up:2.1±0.3 years). We applied linear mixed models with terms for biomarker, time and biomarker*time interactions, adjusted for age, sex, education, and site, to assess associations between biomarkers and cognitive decline.
Results:
Among patients, Aβ42/40 was not associated with cognitive performance at baseline. However, lower Aβ42/40 was associated with steeper decline in global cognition (β±SE:0.04±0.02). Higher pTau181 was associated with worse baseline performance on global cognition (-0.14±0.04) and memory (-0.31±0.09) and with steeper decline in global cognition (-0.07±0.02), memory (-0.09±0.04), attention (-0.05±0.02), and language (-0.10±0.03). Higher GFAP was associated with worse baseline performance on global cognition (-0.22±0.05), memory (-0.43±0.10), attention (-0.14±0.06), language (-0.15±0.05), and executive functioning (-0.15±0.05) and steeper decline in global cognition (-0.05±0.01). Higher NfL was associated with worse baseline performance on global cognition (-0.16±0.04), memory (-0.28±0.09), attention (-0.20±0.06), and executive functioning (-0.10±0.04), but was not associated with performance over time. In reference participants, no associations were found.
Conclusions:
Our findings suggest that blood-based biomarkers of AD-related pathology predict cognitive decline in patients with cardiovascular diseases.
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