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Vascular burden and Alzheimer disease pathologic progression
Open accessAbstract
OBJECTIVE: To investigate the vascular contribution to longitudinal changes in Alzheimer disease (AD) biomarkers. METHODS: The Alzheimer's Disease Neuroimaging Initiative is a clinic based, longitudinal study with CSF, PET, and MRI biomarkers repeatedly measured in participants with normal cognition (NC), mild cognitive impairment (MCI), and mild AD. Participants with severe cerebrovascular risks were excluded. Cardiovascular risk scores and MRI white matter hyperintensities (WMHs) were treated as surrogate markers for vascular burden. Generalized estimating equations were applied, and both vascular burden and its interaction with time (vascular burden × time) or time-varying WMHs were entered into regression models to assess whether biomarker rates of change were modified by vascular burden. RESULTS: Cardiovascular risk profiles were not predictive of progression in CSF β₄₂-amyloid, [¹⁸F]fluorodeoxyglucose (FDG) PET uptake, and MRI hippocampal atrophy. Greater baseline cardiovascular risks or WMHs were generally associated with cognitive impairment, particularly poor executive function. WMHs increased over time with a faster rate in MCI and AD than in NC. Increased time-varying WMH was associated with faster decline in executive function and lower FDG uptake in NC. Otherwise, WMH was not associated with CSF and MRI biomarkers in the 3 groups. These findings remained unchanged after accounting for APOE4. CONCLUSION: Increased WMHs are associated with aging, decreased glucose metabolism, and decline in executive function but do not affect AD-specific pathologic progression, suggesting that the vascular contribution to dementia is probably additive although not necessarily independent of the amyloid pathway.
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“Modern CSF biomarkers may support a direct relationship between SVD and AD pathology [195], although in the Alzheimer Disease Neuroimaging Initiative that is focused on AD, no interactions were noted between vascular risk factors and AD biomarkers [26].”
From The overlap between vascular disease and Alzheimer’s disease - lessons from pathology (2014) · cites this paper as [26]
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Metadata
- Authors
- Lo, R. Y., Jagust, W. J., Weiner, M., Aisen, P., Weiner, M., Aisen, P., Petersen, R., Jack, C. R., Jagust, W., Trojanowki, J. Q., Toga, A. W., Beckett, L., Green, R. C., Saykin, A. J., Morris, J., Liu, E., Green, R. C., Montine, T., Petersen, R., Aisen, P., Gamst, A., Thomas, R. G., Donohue, M., Walter, S., Gessert, D., Sather, T., Beckett, L., Harvey, D., Gamst, A., Donohue, M., Kornak, J., Jack, C. R., Dale, A., Bernstein, M., Felmlee, J., Fox, N., Thompson, P., Schuff, N., Alexander, G., DeCarli, C., Jagust, W., Bandy, D., Koeppe, R. A., Foster, N., Reiman, E. M., Chen, K., Mathis, C., Morris, J., Cairns, N. J., Taylor-Reinwald, L., Trojanowki, J. Q., Shaw, L., Lee, V. M. Y., Korecka, M., Toga, A. W., Crawford, K., Neu, S., Saykin, A. J., Foroud, T. M., Potkin, S., Shen, L., Kachaturian, Z., Frank, R., Snyder, P. J., Molchan, S., Kaye, J., Quinn, J., Lind, B., Dolen, S., Schneider, L. S., Pawluczyk, S., Spann, B. M., Brewer, J., Vanderswag, H., Heidebrink, J. L., Lord, J. L., Petersen, R., Johnson, K., Doody, R. S., Villanueva-Meyer, J., Chowdhury, M., Stern, Y., Honig, L. S., Bell, K. L., Morris, J. C., Ances, B., Carroll, M., Leon, S., Mintun, M. A., Schneider, S., Marson, D., Griffith, R., Clark, D., Grossman, H., Mitsis, E., Romirowsky, A., deToledo-Morrell, L., Shah, R. C., Duara, R., Varon, D., Roberts, P., Albert, M., Onyike, C., Kielb, S., Rusinek, H., de Leon, M. J., Glodzik, L., De Santi, S., Doraiswamy, P. M., Petrella, J. R., Coleman, R. E., Arnold, S. E., Karlawish, J. H., Wolk, D., Smith, C. D., Jicha, G., Hardy, P., Lopez, O. L., Oakley, M., Simpson, D. M., Porsteinsson, A. P., Goldstein, B. S., Martin, K., Makino, K. M., Ismail, M. S., Brand, C., Mulnard, R. A., Thai, G., Mc-Adams-Ortiz, C., Womack, K., Mathews, D., Quiceno, M., Diaz-Arrastia, R., King, R., Weiner, M., Martin-Cook, K., DeVous, M., Levey, A. I., Lah, J. J., Cellar, J. S., Burns, J. M., Anderson, H. S., Swerdlow, R. H., Apostolova, L., Lu, P. H., Bartzokis, G., Silverman, D. H. S., Graff-Radford, N. R., Parfitt, F., Johnson, H., Farlow, M. R., Hake, A. M., Matthews, B. R., Herring, S., van Dyck, C. H., Carson, R. E., MacAvoy, M. G., Chertkow, H., Bergman, H., Hosein, C., Black, S., Stefanovic, D. B., Caldwell, C., Hsiung, G.-Y. R., Feldman, H., Mudge, B., Assaly, M., Kertesz, A., Rogers, J., Trost, D., Bernick, C., Munic, D., Kerwin, D., Mesulam, M.-M., Lipowski, K., Wu, C.-K., Johnson, N., Sadowsky, C., Martinez, W., Villena, T., Turner, R. S., Johnson, K., Reynolds, B., Sperling, R. A., Johnson, K. A., Marshall, G., Frey, M., Yesavage, J., Taylor, J. L., Lane, B., Rosen, A., Tinklenberg, J., Sabbagh, M., Belden, C., Jacobson, S., Kowall, N., Killiany, R., Budson, A. E., Norbash, A., Johnson, P. L., Obisesan, T. O., Wolday, S., Bwayo, S. K., Lerner, A., Hudson, L., Ogrocki, P., Fletcher, E., Carmichael, O., Olichney, J., DeCarli, C., Kittur, S., Borrie, M., Lee, T.-Y., Bartha, D. R., Johnson, S., Asthana, S., Carlsson, C. M., Potkin, S. G., Preda, A., Nguyen, D., Tariot, P., Fleisher, A., Reeder, S., Bates, V., Capote, H., Rainka, M., Scharre, D. W., Kataki, M., Zimmerman, E. A., Celmins, D., Brown, A. D., Pearlson, G. D., Blank, K., Anderson, K., Saykin, A. J., Santulli, R. B., Schwartz, E. S., Sink, K. M., Williamson, J. D., Garg, P., Watkins, F., Ott, B. R., Querfurth, H., Tremont, G., Salloway, S., Malloy, P., Correia, S., Rosen, H. J., Miller, B. L., Mintzer, J., Longmire, C. F., Spicer, K., Finger, E., Rachinsky, I., Rogers, J., Kertesz, A., & Drost, D.
- Affiliations
- Lawrence Berkeley National Laboratory (US)
- From the Division of Epidemiology, School of Public Health (R.Y.L., W.J.J.), and Helen Wills Neuroscience Institute (W.J.J.), University of California, Berkeley; Department of Neurology (R.Y.L.), Buddhist Tzu Chi General Hospital, Hualien, Taiwan; College of Medicine (R.Y.L.), Tzu Chi University, Hualien, Taiwan; and Life Sciences Division (W.J.J.), Lawrence Berkeley National Laboratory, Berkeley, CA.
- U Pennsylvania
- Janssen Alzheimer Immunotherapy
- University of Washington (US)
- University of California San Diego (US)
- University of California, Davis (US)
- Mayo Clinic, Rochester
- Mayo Clinic (US)
- University of London (GB)
- University of California, Los Angeles (US)
- University of California, San Francisco (US)
- Banner Alzheimer’s Institute (US)
- University of Michigan (US)
- University of Utah (US)
- University of Pittsburgh
- Washington University in St. Louis (US)
- Washington University St. Louis
- UPenn School of Medicine (Core PI)
- University of Pennsylvania (US)
- Indiana University (US)
- UC Irvine
- Buddhist Tzu Chi General Hospital (TW)
- Alzheimer's Association (US)
- General Electric (United States) (US)
- University of Connecticut (US)
- National Institutes of Health (US)
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- The University of Texas Southwestern Medical Center (US)
- Emory University (US)
- University of Kansas Medical Center (US)
- Mayo Clinic, Jacksonville
- Mayo Clinic in Florida (US)
- Yale University School of Medicine
- Yale University (US)
- Jewish General Hospital (CA)
- Sunnybrook Health Science Centre (CA)
- Sunnybrook Health Sciences, Ontario
- U.B.C. Clinic for AD & Related Disorders
- Cognitive Neurology - St. Joseph's, Ontario
- Cleveland Clinic (US)
- Northwestern University (US)
- Northwestern University
- Palm Beach Neurology (US)
- Premiere Research Inst (Palm Beach Neurology)
- Georgetown University Medical Center (US)
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- Banner Sun Health Research Institute (US)
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- Neurological Care of CNY
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- Wake Forest University Health Sciences (US)
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- Butler Hospital (US)
- Medical University of South Carolina (US)
- St. Joseph's Health Care
- ORCID
- Lo, Raymond Y.
- Liu, Enchi
- Thomas, Ronald G.
- Walter, Sarah
- Harvey, Danielle
- Kornak, John
- Dale, Anders
- Felmlee, Joel
- Fox, Nick
- Thompson, Paul
- Koeppe, Robert A.
- Reiman, Eric M.
- Chen, Kewei
- Lee, Virginia M.Y.
- Korecka, Magdalena
- Crawford, Karen
- Foroud, Tatiana M.
- Shen, Li
- Frank, Richard
- Snyder, Peter J.
- Kaye, Jeffrey
- Schneider, Lon S.
- Heidebrink, Judith L.
- Lord, Joanne L.
- Johnson, Kris
- Stern, Yaakov
- Honig, Lawrence S.
- Bell, Karen L.
- Ances, Beau
- Carroll, Maria
- Marson, Daniel
- Clark, David
- Shah, Raj C.
- Duara, Ranjan
- Albert, Marilyn
- Kielb, Stephanie
- Rusinek, Henry
- Glodzik, Lidia
- Doraiswamy, P. Murali
- Petrella, Jeffrey R.
- Arnold, Steven E.
- Karlawish, Jason H.
- Wolk, David
- Smith, Charles D.
- Hardy, Peter
- Porsteinsson, Anton P.
- Ismail, M. Saleem
- Thai, Gaby
- Womack, Kyle
- Quiceno, Mary
- Diaz-Arrastia, Ramon
- Weiner, Myron
- DeVous, Michael
- Levey, Allan I.
- Lah, James J.
- Burns, Jeffrey M.
- Swerdlow, Russell H.
- Apostolova, Liana
- Lu, Po H.
- Silverman, Daniel H.S.
- Johnson, Heather
- Farlow, Martin R.
- Hake, Ann Marie
- Carson, Richard E.
- Chertkow, Howard
- Bergman, Howard
- Hsiung, Ging-Yuek Robin
- Feldman, Howard
- Bernick, Charles
- Kerwin, Diana
- Johnson, Nancy
- Turner, Raymond Scott
- Sperling, Reisa A.
- Johnson, Keith A.
- Marshall, Gad
- Frey, Meghan
- Yesavage, Jerome
- Taylor, Joy L.
- Lane, Barton
- Rosen, Allyson
- Sabbagh, Marwan
- Belden, Christine
- Jacobson, Sandra
- Kowall, Neil
- Killiany, Ronald
- Budson, Andrew E.
- Norbash, Alexander
- Obisesan, Thomas O.
- Lerner, Alan
- Carmichael, Owen
- Olichney, John
- Johnson, Sterling
- Asthana, Sanjay
- Carlsson, Cynthia M.
- Preda, Adrian
- Nguyen, Dana
- Tariot, Pierre
- Fleisher, Adam
- Scharre, Douglas W.
- Kataki, Maria
- Pearlson, Godfrey D.
- Santulli, Robert B.
- Sink, Kaycee M.
- Williamson, Jeff D.
- Garg, Pradeep
- Ott, Brian R.
- Tremont, Geoffrey
- Salloway, Stephen
- Correia, Stephen
- Rosen, Howard J.
- Miller, Bruce L.
- Mintzer, Jacobo
- Venue
- Neurology
- Published
- 2012-09-25
- Volume
- 79
- Issue
- 13
- Pages
- 1349-1355
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- PMC
- PMC3448744
- OpenAlex
- W2055568131
- Cited by
- 156
- References
- 36
- Citations by year
- 2026: 5 · 2025: 4 · 2024: 5 · 2023: 6 · 2022: 4 · 2021: 12 · 2020: 9 · 2019: 10 · 2018: 9 · 2017: 11 · 2016: 18 · 2015: 25 · 2014: 24 · 2013: 13
- FWCI
- 14.16
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Neurology (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Columbia Academic Commons (Columbia University)
- Funders
- National Institutes of Health (5u01ag024904-10)
- Canadian Institutes of Health Research
- National Institute on Aging (U01-AG-024904, P30AG010129, K01AG030514, P30AG013846, U19AG010483)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Neurology › Neurological Disease Mechanisms and Treatments
- Health Sciences › Medicine › Clinical Neurology › Cerebrovascular and genetic disorders
- Keywords
- Alzheimer's disease, vascular burden, white matter hyperintensities, cardiovascular risk, mild cognitive impairment, CSF amyloid-beta 42, hippocampal atrophy, executive function decline, APOE ε4, disease progression
- MeSH terms
- Aged, Alzheimer Disease, Atrophy, Brain, Female, Genotype, Humans, Longitudinal Studies, Magnetic Resonance Imaging, Male, Disease Progression, Positron-Emission Tomography, Leukoencephalopathies, Cognitive Dysfunction
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Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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