Jefferson Angela L, Gifford Katherine A, Acosta Lealani Mae Y, Bell Susan P, Donahue Manus J, Davis L Taylor, Gottlieb JoAnn, Gupta Deepak K, Hohman Timothy J, Lane Elizabeth M, Libon David J, Mendes Lisa A, Niswender Kevin, Pechman Kimberly R, Rane Swati, Ruberg Frederick L, Su Yan Ru, Zetterberg Henrik, Liu Dandan
Vanderbilt Memory & Alzheimer's Center, Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
Division of Cardiovascular Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
J Alzheimers Dis. 2016 Mar 8;52(2):539-59. doi: 10.3233/JAD-150914.
Vascular health factors frequently co-occur with Alzheimer's disease (AD). A better understanding of how systemic vascular and cerebrovascular health intersects with clinical and pathological AD may inform prevention and treatment opportunities.
To establish the Vanderbilt Memory & Aging Project, a case-control longitudinal study investigating vascular health and brain aging, and describe baseline methodology and participant characteristics.
From September 2012 to November 2014, 335 participants age 60- 92 were enrolled, including 168 individuals with mild cognitive impairment (MCI, 73±8 years, 41% female) and 167 age-, sex-, and race-matched cognitively normal controls (NC, 72±7 years, 41% female). At baseline, participants completed a physical and frailty examination, fasting blood draw, neuropsychological assessment, echocardiogram, cardiac MRI, and brain MRI. A subset underwent 24-hour ambulatory blood pressure monitoring and lumbar puncture for cerebrospinal fluid (CSF) collection.
As designed, participant groups were comparable for age (p = 0.31), sex (p = 0.95), and race (p = 0.65). MCI participants had greater Framingham Stroke Risk Profile scores (p = 0.008), systolic blood pressure values (p = 0.008), and history of left ventricular hypertrophy (p = 0.04) than NC participants. As expected, MCI participants performed worse on all neuropsychological measures (p-values < 0.001), were more likely to be APOEɛ4 carriers (p = 0.02), and had enhanced CSF biomarkers, including lower Aβ42 (p = 0.02), higher total tau (p = 0.004), and higher p-tau (p = 0.02) compared to NC participants.
Diverse sources of baseline and longitudinal data will provide rich opportunities to investigate pathways linking vascular and cerebrovascular health, clinical and pathological AD, and neurodegeneration contributing to novel strategies to delay or prevent cognitive decline.
血管健康因素常与阿尔茨海默病（AD）同时出现。更好地理解全身血管和脑血管健康如何与临床及病理AD相互关联，可能为预防和治疗提供契机。
建立范德比尔特记忆与衰老项目，一项调查血管健康与脑衰老的病例对照纵向研究，并描述基线方法和参与者特征。
2012年9月至2014年11月，招募了335名60 - 92岁的参与者，包括168名轻度认知障碍（MCI，73±8岁，41%为女性）个体和167名年龄、性别及种族匹配的认知正常对照（NC，72±7岁，41%为女性）。在基线时，参与者完成了体格和衰弱检查、空腹抽血、神经心理学评估、超声心动图、心脏磁共振成像和脑磁共振成像。一部分人接受了24小时动态血压监测，并进行腰椎穿刺以收集脑脊液（CSF）。
按照设计，参与者组在年龄（p = 0.31）、性别（p = 0.95）和种族（p = 0.65）方面具有可比性。MCI参与者的弗雷明汉卒中风险评分（p = 0.008）、收缩压值（p = 0.008）以及左心室肥厚病史（p = 0.04）均高于NC参与者。正如预期的那样，MCI参与者在所有神经心理学测量中的表现更差（p值<0.001），更有可能是APOEɛ4携带者（p = 0.02），并且与NC参与者相比，其脑脊液生物标志物有所增强，包括较低的Aβ42（p = 0.02）、较高的总tau（p = 0.004）和较高的p - tau（p = 0.02）。
多样的基线和纵向数据来源将为研究连接血管和脑血管健康、临床及病理AD以及神经退行性变的途径提供丰富机会，从而有助于制定延缓或预防认知衰退的新策略。
