Vascular risk factors and cerebrovascular pathologic changes on autopsy: The 90+ Study

Area of Science:

• Neurology
• Gerontology
• Pathology

Background:

• Cerebrovascular pathologic changes (CVPC) are common in individuals aged 90 and older and are linked to dementia.
• Associations between CVPC and traditional risk factors like hypertension, diabetes, and hyperlipidemia are inconsistent.

Purpose of the Study:

• To investigate the association between traditional vascular risk factors and their medications with the presence of CVPC in the oldest adults.
• To test the hypothesis that neither risk factors nor medications are associated with CVPC.

Main Methods:

• Analysis of autopsy data from 267 participants (mean age 98 years) in The 90+ Study.
• Logistic regression models were used to calculate odds ratios (OR) for CVPC presence, adjusting for age, sex, and education.

Main Results:

• CVPC presence was not associated with traditional vascular risk factors.
• Diuretic use was associated with lower odds of atherosclerosis (OR 0.55).
• Beta-blocker (OR 0.57) and vasodilator (OR 0.40) use were associated with lower odds of cerebral amyloid angiopathy (CAA).

Conclusions:

• Traditional vascular risk factors may not be significant risk factors for CVPC in extreme old age.
• Antihypertensive medications might mitigate the risk or presence of certain cerebrovascular changes.
• Survival bias could potentially obscure observed associations.