Midlife Atherosclerosis and Development of Alzheimer or Vascular Dementia
(2020) In Annals of Neurology 87(1). p.52-62- Abstract
Objective: To investigate whether midlife atherosclerosis is associated with different dementia subtypes and related underlying pathologies. Methods: Participants comprised the cardiovascular cohort of the Swedish prospective population-based Malmö Diet and Cancer Study (N = 6,103). Carotid plaques and intima media thickness (IMT) were measured at baseline (1991–1994). Dementia incidence until 2014 was obtained from national registers. Diagnoses were reviewed and validated in medical records. In a cognitively unimpaired subcohort (n = 330), β-amyloid42 and tau were quantified in cerebrospinal fluid (CSF), and white matter hyperintensity volume, lacunar infarcts, and cerebral microbleeds were estimated on magnetic resonance... (More)
Objective: To investigate whether midlife atherosclerosis is associated with different dementia subtypes and related underlying pathologies. Methods: Participants comprised the cardiovascular cohort of the Swedish prospective population-based Malmö Diet and Cancer Study (N = 6,103). Carotid plaques and intima media thickness (IMT) were measured at baseline (1991–1994). Dementia incidence until 2014 was obtained from national registers. Diagnoses were reviewed and validated in medical records. In a cognitively unimpaired subcohort (n = 330), β-amyloid42 and tau were quantified in cerebrospinal fluid (CSF), and white matter hyperintensity volume, lacunar infarcts, and cerebral microbleeds were estimated on magnetic resonance imaging (2009–2015). Results: During 20 years of follow-up, 462 individuals developed dementia (mean age at baseline = 57.5 ± 5.9 years, 58% women). Higher IMT in midlife was associated with an increased hazard ratio (HR) of all-cause dementia (adjusted HR = 1.14 [95% confidence interval (CI) = 1.03–1.26]) and vascular dementia (adjusted HR = 1.32 [95% CI = 1.10–1.57]) but not Alzheimer disease (AD) dementia (adjusted HR = 0.95 [95% CI = 0.77–1.17]). Carotid plaques were associated with vascular dementia when assessed as a 3-graded score (adjusted HR = 1.90 [95% CI = 1.07–3.38]). In the cognitively unimpaired subcohort (53.8 ± 4.6 years at baseline, 60% women), higher IMT in midlife was associated with development of small vessel disease (adjusted odds ratio [OR] = 1.47 [95% CI = 1.05–2.06]) but not significantly with abnormal CSF AD biomarkers (adjusted OR = 1.28 [95% CI = 0.87–1.90] for Aβ42 and 1.35 [95% CI = 0.86–2.13] for Aβ42/p-tau). Carotid plaques revealed no significant association with any of the underlying brain pathologies. Interpretation: Our findings support an association between midlife atherosclerosis and development of vascular dementia and cerebral small vessel disease but not between atherosclerosis and subsequent AD dementia or AD pathology.
(Less)
- author
- Gustavsson, Anna Märta LU ; van Westen, Danielle LU ; Stomrud, Erik LU ; Engström, Gunnar LU ; Nägga, Katarina LU and Hansson, Oskar LU
- organization
- publishing date
- 2020-01
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Annals of Neurology
- volume
- 87
- issue
- 1
- pages
- 11 pages
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- scopus:85075725346
- pmid:31721283
- ISSN
- 0364-5134
- DOI
- 10.1002/ana.25645
- language
- English
- LU publication?
- yes
- id
- ace92087-d873-44cb-bd7c-f28a76fbfa98
- date added to LUP
- 2019-12-17 16:24:48
- date last changed
- 2024-09-18 15:08:20
@article{ace92087-d873-44cb-bd7c-f28a76fbfa98, abstract = {{<p>Objective: To investigate whether midlife atherosclerosis is associated with different dementia subtypes and related underlying pathologies. Methods: Participants comprised the cardiovascular cohort of the Swedish prospective population-based Malmö Diet and Cancer Study (N = 6,103). Carotid plaques and intima media thickness (IMT) were measured at baseline (1991–1994). Dementia incidence until 2014 was obtained from national registers. Diagnoses were reviewed and validated in medical records. In a cognitively unimpaired subcohort (n = 330), β-amyloid<sub>42</sub> and tau were quantified in cerebrospinal fluid (CSF), and white matter hyperintensity volume, lacunar infarcts, and cerebral microbleeds were estimated on magnetic resonance imaging (2009–2015). Results: During 20 years of follow-up, 462 individuals developed dementia (mean age at baseline = 57.5 ± 5.9 years, 58% women). Higher IMT in midlife was associated with an increased hazard ratio (HR) of all-cause dementia (adjusted HR = 1.14 [95% confidence interval (CI) = 1.03–1.26]) and vascular dementia (adjusted HR = 1.32 [95% CI = 1.10–1.57]) but not Alzheimer disease (AD) dementia (adjusted HR = 0.95 [95% CI = 0.77–1.17]). Carotid plaques were associated with vascular dementia when assessed as a 3-graded score (adjusted HR = 1.90 [95% CI = 1.07–3.38]). In the cognitively unimpaired subcohort (53.8 ± 4.6 years at baseline, 60% women), higher IMT in midlife was associated with development of small vessel disease (adjusted odds ratio [OR] = 1.47 [95% CI = 1.05–2.06]) but not significantly with abnormal CSF AD biomarkers (adjusted OR = 1.28 [95% CI = 0.87–1.90] for Aβ<sub>42</sub> and 1.35 [95% CI = 0.86–2.13] for Aβ<sub>42</sub>/p-tau). Carotid plaques revealed no significant association with any of the underlying brain pathologies. Interpretation: Our findings support an association between midlife atherosclerosis and development of vascular dementia and cerebral small vessel disease but not between atherosclerosis and subsequent AD dementia or AD pathology. </p>}}, author = {{Gustavsson, Anna Märta and van Westen, Danielle and Stomrud, Erik and Engström, Gunnar and Nägga, Katarina and Hansson, Oskar}}, issn = {{0364-5134}}, language = {{eng}}, number = {{1}}, pages = {{52--62}}, publisher = {{John Wiley & Sons Inc.}}, series = {{Annals of Neurology}}, title = {{Midlife Atherosclerosis and Development of Alzheimer or Vascular Dementia}}, url = {{http://dx.doi.org/10.1002/ana.25645}}, doi = {{10.1002/ana.25645}}, volume = {{87}}, year = {{2020}}, }