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. 2015 Dec 1;85(22):1930-6.
doi: 10.1212/WNL.0000000000002175. Epub 2015 Nov 4.

Cerebral amyloid angiopathy and cognitive outcomes in community-based older persons

Patricia A Boyle  1 , Lei Yu  2 , Sukriti Nag  2 , Sue Leurgans  2 , Robert S Wilson  2 , David A Bennett  2 , Julie A Schneider  2
Affiliations

Cerebral amyloid angiopathy and cognitive outcomes in community-based older persons

Patricia A Boyle et al. Neurology. .

Abstract

Objective: We tested the hypothesis that cerebral amyloid angiopathy (CAA) is related to Alzheimer disease (AD) dementia and decline in multiple cognitive systems in old age, independent of AD plaque and tangle pathology and other common age-related neuropathologies.

Methods: Participants (n = 1,113) came from 2 longitudinal clinical-pathologic studies of aging, the Rush Memory and Aging Project and the Religious Orders Study. All underwent annual clinical evaluations including detailed cognitive testing for a mean of 7.1 years before death. Clinical diagnoses of AD were established after reviewing all clinical data, blinded to neuropathologic information. Neuropathologic examinations provided measures of CAA, AD pathology, macroscopic infarcts, microinfarcts, and neocortical Lewy bodies. The association of CAA with AD dementia was examined using logistic regression models, and its association with cognitive decline was examined using linear mixed models.

Results: CAA was common, present in 78.9% of participants, and moderately related to AD pathology (ρ = 0.401, p < 0.0001). In analyses adjusted for plaques, tangles, and other common age-related neuropathologies, CAA was associated with an increased odds of AD dementia (odds ratio = 1.237, 95% confidence interval 1.082-1.414) and an increased rate of decline in global cognition, perceptual speed, episodic memory, and semantic memory. The associations of CAA with cognitive outcomes were not driven by the presence of capillary involvement.

Conclusions: CAA is an important determinant of AD dementia and decline in multiple cognitive systems in old age.

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Figures

Figure 1
Figure 1. Association of CAA pathology with AD dementia for persons with no, mild, moderate, and severe CAA
Derived from a logistic regression model adjusted for age, sex, education, AD pathology, macro- and microscopic infarcts, and Lewy bodies. AD = Alzheimer disease; CAA = cerebral amyloid angiopathy.
Figure 2
Figure 2. Association of cerebral amyloid angiopathy pathology with decline in global cognition
Derived from a mixed-effects model adjusted for age, sex, education, Alzheimer disease pathology, macro- and microscopic infarcts, and Lewy bodies.
See this image and copyright information in PMC

References

    1. Thal DR, Ghebremedhin E, Orantes M, Wiestler OD. Vascular pathology in Alzheimer disease: correlation of cerebral amyloid angiopathy and arteriosclerosis/lipohyalinosis with cognitive decline. J Neuropathol Exp Neurol 2003;62:1287–1301. - PubMed
    1. Attems J, Jellinger KA. Only cerebral capillary amyloid angiopathy correlates with Alzheimer pathology: a pilot study. Acta Neuropathol 2004;107:83–90. - PubMed
    1. Matthews FE, Brayne C, Lowe J, McKeith I, Wharton SB, Ince P. Epidemiological pathology of dementia: attributable-risks at death in the Medical Research Council Cognitive Function and Ageing Study. PloS Med 2009;6:e1000180. - PMC - PubMed
    1. Itoh Y, Yamada M, Hayakawa M, Otomo E, Miyatake T. Cerebral amyloid angiopathy: a significant cause of cerebellar as well as lobar cerebral hemorrhage in the elderly. J Neurol Sci 1993;116:135–141. - PubMed
    1. Esiri M, Chance S, Joachim C, et al. Cerebral amyloid angiopathy, subcortical white matter disease and dementia: literature review and study in OPTIMA. Brain Pathol 2015;25:51–62. - PMC - PubMed

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