Arterial Stiffness is Associated with Amyloid-Beta Deposition and Lower Brain Volume in Alzheimer Disease-Susceptible Regions

 

Results from the atherosclerosis risk in communities (ARIC)-neurocognitive study published today (Neurology. 2018;published online ahead of print March 16, 2018) show an association between arterial stiffness and pathology linked to Alzheimer’s disease (AD) and dementia.

Subjects in the study underwent PET scanning with florbetapir ([18F]-AV-45) for quantitative measurement of uptake volume ratios and definition of global Aß-positivity. Subjects also had brain MRIs to identify cerebral small vessel disease (cSVD) and detailed cognitive testing to identify or verify the presence of dementia and/or mild cognitive impairment (MCI). Arterial stiffness was measured by pulse wave velocity (PWV). Cross-sectional analyses of results were performed to adjust for age, body mass index, sex, race, APOE4 status, and cognitive status.

Arterial stiffness as measured by heart-carotid PWV was associated with greater Aß deposition (odds ratio [OR] = 1.31, 95% confidence interval [CI] 1.01-1.71). Central arterial stiffness as measured by carotid-femoral PWV correlated with a higher odds of high white matter hyperintensity (OR 1.6, 95% CI 1.2-2.1), Ab-positive scans (OR 1.4, 95% CI 1.1-2.1), and lower brain volumes in AD—susceptible regions (in mm3 b = -1.5 [0.7 SD] P = .03).  Of note, the associations were strongest in individuals with MCI and did not differ by race or APOE4 status. These findings confirm those of earlier studies that observed a relationship between arterial stiffness and Aß deposition, furthering the idea that systemic vascular disease and Aß deposition are linked. 

 

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