French Scott R, Arias Juan C, Zahra Summan, Ally Madeline, Escareno Cris, Heitkamp Emma, Vazquez Franchell, Hillis Madison, Wiskoski Haley, Ainapurapu Karthik, Culwell Gavin, Howell Caronae, Johnson Kevin, Kraemer Cody, Pacanowski John, Leon Luis, Berman Scott, Yanquez Federico, Balderman Joshua, Sabat Joseph, Hung Olivia, Lucas Layla, Vitali Francesca, Bedrick Edward J, Mushtaq Raza, Altbach Maria, Trouard Theodore P, Elahi Fanny M, Ashton Nicholas J, Dage Jeffrey L, Reiman Eric M, Alexander Gene E, Weinkauf Craig C
The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Department of Psychology, University of Arizona, Tucson, Arizona, USA.
Alzheimers Dement. 2025 Aug;21(8):e70565. doi: 10.1002/alz.70565.
Vascular comorbidities are modifiable contributors to cognitive impairment and Alzheimer's disease (AD), yet brain health outcomes are rarely evaluated in cardiovascular patients.
This study prospectively evaluated cognition and AD pathology in 162 community-dwelling adults with asymptomatic cardiovascular disease who did not have a clinical diagnosis of dementia or cognitive impairment.
Twenty-nine percent of the cohort had Montreal Cognitive Assessment (MoCA) scores indicative of cognitive impairment or dementia after adjusting for age, sex, and education based on National Alzheimer's Coordinating Center normative data. AD blood biomarker phosphorylated tau217 was elevated in 55% of the cohort, significantly associated with decreased MoCA scores (β = -1.46, 95% confidence interval [CI] -2.53 to -0.39, p < 0.01), and accurately differentiated cognitive impairment (area under the curve 0.94, 95% CI 0.88-0.99).
This level of undiagnosed cognitive impairment and AD pathology exceeds what would be expected in the general population and highlights a potential need for screening and future work to better identify treatment options.
Brain health outcomes are rarely evaluated in vascular patients. One hundred sixty-two adults with asymptomatic cardiovascular disease but without diagnoses of cognitive impairment or dementia were evaluated. Phosphorylated tau217 accurately differentiated cognitive impairment in patients with cardiovascular disease. High levels of cognitive impairment and Alzheimer's disease pathology are greatly underdiagnosed in the cardiovascular population.
血管合并症是导致认知障碍和阿尔茨海默病（AD）的可改变因素，但心血管疾病患者的脑健康状况很少得到评估。
本研究前瞻性评估了162名无症状心血管疾病的社区居住成年人的认知和AD病理情况，这些患者没有痴呆或认知障碍的临床诊断。
根据国家阿尔茨海默病协调中心的规范数据，在对年龄、性别和教育程度进行调整后，29%的队列参与者蒙特利尔认知评估（MoCA）得分表明存在认知障碍或痴呆。55%的队列参与者AD血液生物标志物磷酸化tau217升高，与MoCA得分降低显著相关（β=-1.46，95%置信区间[CI]-2.53至-0.39，p<0.01），并能准确区分认知障碍（曲线下面积0.94，95%CI 0.88-0.99）。
这种未被诊断出的认知障碍和AD病理水平超过了一般人群的预期，凸显了筛查以及未来开展工作以更好地确定治疗方案的潜在必要性。
血管疾病患者的脑健康状况很少得到评估。对162名无症状心血管疾病但未诊断出认知障碍或痴呆的成年人进行了评估。磷酸化tau217能准确区分心血管疾病患者的认知障碍。心血管人群中高水平的认知障碍和阿尔茨海默病病理状况在很大程度上未被诊断出来。
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