Associations of Vascular Risk with Cognition, Brain Glucose Metabolism, and Clinical Progression in Cognitively Intact Elders

Article type: Research Article

Authors: Yu, Guang-Xiang^{a; b} | Zhang, Ting^c | Hou, Xiao-He^d | Ou, Ya-Nan^d | Hu, Hao^d | Wang, Zuo-Teng^d | Guo, Yu^d | Xu, Wei^d | Tan, Lin^d | Yu, Jin-Tai^{c; *} | Tan, Lan^{a; d; *} | Alzheimer’s Disease Neuroimaging Initiative¹

Affiliations: [a] Department of Neurology, Qingdao Municipal Hospital, Dalian Medical University, Dalian, China | [b] Department of Neurology, The First Affiliated Hospital of Dalian Medical University, Dalian, China | [c] Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China | [d] Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China

Correspondence: [*] Correspondence to: Lan Tan, MD, PhD, Department of Neu-rology, Qingdao Municipal Hospital, Dalian Medical University, No.5 Donghai Middle Road, Qingdao, China. E-mail: dr.tanlan@163.com and Jin-Tai Yu, MD, PhD, Department of Neurology, Hu-ashan Hospital, Fudan University, No. 12 Wulumuqi Road, Shanghai, China. Tel.: +86 21 52888160; Fax: +86 21 62483421; E-mail: jintai_yu@fudan.edu.cn.

Note: [1] Data used in preparation for this article were obtained from the Alzheimer s Disease Neuroimaging Initiative (ADNI) database (http://adni.loni.usc.edu). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in the analysis or writing of this report. A complete listing of ADNI investigators can be fo-und at: http://adni.loni.usc.edu/wp-content/uploads/how_to_apply/ADNI_Acknowledgement_List.pdf.

Abstract: Background:Increasing evidence supports an important role of vascular risk in cognitive decline and dementia. Objective:This study aimed to examine whether vascular risk was associated with cognitive decline, cerebral hypometabolism, and clinical progression in cognitively intact elders. Methods:Vascular risk was assessed by the Framingham Heart Study general Cardiovascular disease (FHS-CVD) risk score. The cross-sectional and longitudinal associations of FHS-CVD risk score with cognition and brain glucose metabolism were explored using multivariate linear regression and linear mixed effects models, respectively. The risk of clinical progression conversion was assessed using Kaplan-Meier survival curves and multivariate Cox proportional hazard models. Results:A total of 491 cognitively intact elders were included from Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. Participants with high FHS-CVD risk scores had lower baseline Mini-Mental State Examination (MMSE) (p = 0.009), executive function (EF) (p < 0.001), memory function (MEM) (p < 0.001) scores, and F18-fluorodeoxyglucose positron emission tomography (FDG-PET) uptake (p < 0.001) than those with low FHS-CVD risk scores. In longitudinal analyses, individuals with higher FHS-CVD risk scores had greater longitudinal declines in MMSE (p = 0.043), EF (p = 0.029) scores, and FDG-PET uptake (p = 0.035). Besides, individuals with a higher vascular risk had an increased risk of clinical progression (p = 0.004). Conclusion:These findings indicated effects of vascular risk on cognitive decline, cerebral hypometabolism, and clinical progression. Early detection and management of vascular risk factors might be useful in the prevention of dementia.

Keywords: Clinical progression, cognition, dementia, FDG-PET, vascular risk

DOI: 10.3233/JAD-201117

Journal: Journal of Alzheimer's Disease, vol. 80, no. 1, pp. 321-330, 2021