Alzheimer Dementia: How do vascular risk factors affect brain and cognitive function?

Alzheimer's disease (AD) is a progressive neurodegenerative disease characterized by decreased pathology and cognitive ability of β-amyloid (Aβ) and tau in the brain, which ultimately leads to dementia

Although AD and SVD are considered to be independent processes, vascular risk factors (VRFs) are related to these two forms of disease

VRFs are also used for risk stratification in dementia prevention trials

The Multi-Ethnic Study of Atherosclerosis (MESA) is a unique and diverse study with a wide range of longitudinal vascular phenotypes over 20 years, and cognitive tests 10 and 15 years later

In this study, they explored: (1) various comprehensive VRF indicators, (2) imaging biomarkers of SVD and AD-related pathologies, and (3) the relationship between cognitive performance and cognitive changes.

They explored baseline VRFs, cognitive tests, and neuroimaging measurements (β-amyloid [Aβ] PET, MRI).

Compared with whites, African Americans exhibit greater baseline cardiovascular risk factors, incidence of aging and dementia (CAIDE), Framingham Stroke Risk Profile (FSRP), and risk of atherosclerotic cardiovascular disease Assessment (ASCVD) score

There were no significant ethnic differences in Aβ positive rate, cortical thickness, or white matter hyperintensity (WMH) volume

A higher baseline VRF score is related to lower cortical thickness and larger WMH volume, while FSRP and CAIDE are related to Aβ

This study shows that multiple vascular risk factors can jointly affect dementia and Alzheimer's disease, which is the basis for neurodegeneration and cognitive decline