Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
Alzheimer's Disease Research Center, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
Alzheimers Dement. 2022 Apr;18(4):551-560. doi: 10.1002/alz.12429. Epub 2021 Sep 5.
Little is known about how antecedent vascular risk factor (VRF) profiles impact late-life brain health.
We examined baseline VRFs, and cognitive testing and neuroimaging measures (β-amyloid [Aβ] PET, MRI) in a diverse longitudinal cohort (N = 159; 50% African-American, 50% White) from Wake Forest's Multi-Ethnic Study of Atherosclerosis Core.
African-Americans exhibited greater baseline Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE), Framingham stroke risk profile (FSRP), and atherosclerotic cardiovascular disease risk estimate (ASCVD) scores than Whites. We observed no significant racial differences in Aβ positivity, cortical thickness, or white matter hyperintensity (WMH) volume. Higher baseline VRF scores were associated with lower cortical thickness and greater WMH volume, and FSRP and CAIDE were associated with Aβ. Aβ was cross-sectionally associated with cognition, and all imaging biomarkers were associated with greater 6-year cognitive decline.
Results suggest the convergence of multiple vascular and Alzheimer's processes underlying neurodegeneration and cognitive decline.
关于既往血管风险因素 (VRF) 谱如何影响老年期大脑健康，目前知之甚少。
我们在来自维克森林大学动脉粥样硬化多民族研究核心的一个多样化的纵向队列（N=159；50%非洲裔美国人，50%白人）中检查了基线 VRF、认知测试和神经影像学测量（β-淀粉样蛋白 [Aβ] PET、MRI）。
与白人相比，非裔美国人的心血管危险因素、衰老和痴呆发生率（CAIDE）、弗雷明汉中风风险评分（FSRP）和动脉粥样硬化性心血管疾病风险估计（ASCVD）评分的基线更高。我们没有观察到 Aβ 阳性、皮质厚度或白质高信号（WMH）体积的显著种族差异。较高的基线 VRF 评分与较低的皮质厚度和更大的 WMH 体积相关，FSRP 和 CAIDE 与 Aβ 相关。Aβ 与认知呈横断面相关，所有影像学生物标志物均与 6 年内认知衰退的增加相关。
结果表明，多种血管和阿尔茨海默病过程在神经退行性变和认知能力下降中是一致的。
