Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands.
Department of Neurology, UMCG, Groningen, The Netherlands.
J Alzheimers Dis. 2024;97(2):953-961. doi: 10.3233/JAD-230604.
Dementia is a multifactorial disease, with Alzheimer's disease (AD) and vascular pathology often co-occurring in many individuals with dementia. Yet, the interplay between AD and vascular pathology in cognitive decline is largely undetermined.
The aim of the present study was to examine the joint effect of arteriosclerosis and AD pathology on cognition in the general population without dementia.
We determined the interaction between blood-based AD biomarkers and CT-defined arteriosclerosis on cognition in 2,229 dementia-free participants of the population-based Rotterdam Study (mean age: 68.9 years, 52% women) cross-sectionally.
Amyloid-β (Aβ)42 and arterial calcification were associated with cognitive performance. After further adjustment for confounders in a model that combined all biomarkers, only arterial calcification remained independently associated with cognition. There was a significant interaction between arterial calcification and Aβ42 and between arterial calcification and the ratio of Aβ42/40. Yet, estimates attenuated, and interactions were no longer statistically significant after adjustment for cardio metabolic risk factors.
Arteriosclerosis and AD display additive interaction-effects on cognition in the general population, that are due in part to cardio metabolic risk factors. These findings suggest that joint assessment of arteriosclerosis and AD pathology is important for understanding of disease etiology in individuals with cognitive impairment.
痴呆是一种多因素疾病，阿尔茨海默病（AD）和血管病理学通常在许多痴呆患者中同时发生。然而，AD 和血管病理学在认知能力下降中的相互作用在很大程度上尚未确定。
本研究旨在检查无痴呆人群中动脉硬化和 AD 病理学对认知的共同影响。
我们在基于人群的鹿特丹研究（无痴呆症的 2229 名参与者，平均年龄：68.9 岁，52%为女性）中，确定了血液 AD 生物标志物与 CT 定义的动脉硬化之间的相互作用对认知的影响。
淀粉样蛋白-β（Aβ）42 和动脉钙化与认知表现相关。在进一步调整了包含所有生物标志物的模型中的混杂因素后，只有动脉钙化与认知仍然独立相关。动脉钙化与 Aβ42 之间以及动脉钙化与 Aβ42/40 比值之间存在显著的相互作用。然而，在调整了心血管代谢危险因素后，估计值减弱，相互作用不再具有统计学意义。
动脉硬化和 AD 在普通人群中对认知具有相加的相互作用效应，部分归因于心血管代谢危险因素。这些发现表明，联合评估动脉硬化和 AD 病理学对于理解认知障碍个体的疾病病因很重要。
