The Role of Vascular Risk Factors in Biomarker-Based AT(N) Groups: A German-Dutch Memory Clinic Study

Article type: Research Article

Authors: Kučikienė, Domantė^a | Costa, Ana Sofia^{a; b; c} | Banning, Leonie C.P.^d | van Gils, Veerle^d | Schulz, Jörg B.^{a; b; c} | Ramakers, Inez H.G.B.^{a; d} | Verhey, Frans R.J.^d | Vos, Stephanie J.B.^d | Reetz, Kathrin^{a; b; c; *}

Affiliations: [a] Department of Neurology, University Hospital RWTH Aachen, Aachen, Germany | [b] JARA-Institute Molecular Neuroscience and Neuroimaging, Forschungszentrum Jülich, Jülich, Germany | [c] RWTH Aachen University, Aachen, Germany | [d] Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, the Netherlands

Correspondence: [*] Correspondence to: Prof. Kathrin Reetz, MD, Department of Neurology, University Hospital RWTH Aachen & JARA Institute of Molecular Neuroscience and Neuroimaging, Department of Neurology, Pauwelsstr. 30, 52074 Aachen, Germany. Tel.: +49 (0) 241 80 89609; E-mail: kreetz@ukaachen.de.

Abstract: Background:The relation between vascular risk factors (VRFs) and Alzheimer’s disease (AD) is important due to possible pathophysiological association. Objective:To assess the prevalence of VRFs in biomarker-based AT(N) groups and the associations between VRFs, AD cerebrospinal fluid (CSF) biomarkers, brain magnetic resonance imaging (MRI), and cognition in clinical context. Methods:We included patients from two memory clinics in University Hospital Aachen (Germany) and Maastricht University Medical Centre (The Netherlands). Subjects were older than 45 years and had available data on demographics, VRFs, CSF AD biomarkers, and MRI. We categorized individuals in normal AD biomarkers, non-AD change, and AD-continuum groups based on amyloid (A), tau (T), and neurodegeneration (N) status in CSF and MRI. Regression models were corrected for age, sex, and site. Results:We included 838 participants (mean age 68.7, 53.2% male, mean MMSE 24.9). The most common VRFs were smoking (60.9%), hypertension (54.6%), and dyslipidemia (37.8%). Alcohol abuse and smoking were most frequent in the non-AD-change group, and coronary heart disease and carotid artery stenosis in the AD continuum group. Higher rates of depression were found in the normal AD biomarkers group. Parietal atrophy and cortical microbleeds were specific for the AD continuum group. Carotid artery stenosis was associated with pathological Aβ42 and T-tau values, and diabetes and alcohol abuse were associated with worse medial temporal atrophy and atrial fibrillation, with worse cognition. Conclusion:VRFs are common in memory clinic patients, showing differences across the AT(N) biomarker groups. This is important for prevention and individualized treatment of dementia.

Keywords: Alzheimer’s disease, ambulatory care facilities, biomarkers, classification, risk factors, vascular diseases

DOI: 10.3233/JAD-215391

Journal: Journal of Alzheimer's Disease, vol. 87, no. 1, pp. 185-195, 2022