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. 2024 Aug;20(8):5375-5384.
doi: 10.1002/alz.13917. Epub 2024 Jul 10.

Cerebral arteriolosclerosis, lacunar infarcts, and cognition in older Black adults

Debra A Fleischman  1   2   3 , Konstantinos Arfanakis  1   4   5 , Sue E Leurgans  1   2   6 , Zoe Arvanitakis  1   2 , Melissa Lamar  1   3 , S Duke Han  1   7 , Victoria N Poole  1   8 , David A Bennett  1 , Lisa L Barnes  1   2   3
Affiliations

Cerebral arteriolosclerosis, lacunar infarcts, and cognition in older Black adults

Debra A Fleischman et al. Alzheimers Dement. 2024 Aug.

Abstract

Introduction: Older Black adults are at risk of cerebral small vessel disease (CSVD), which contributes to dementia risk. Two subtypes of CSVD, arteriolosclerosis and ischemic lacunar infarcts, have been independently linked to lower cognition and higher dementia risk, but their combined effects on cognition in older Black adults are unclear.

Methods: Mixed models were used to examine the associations of in vivo measures of arteriolosclerosis (ARTS) and ischemic lacunar infarcts to cognitive level and change in 370 older Black adults without dementia. RESULTS: Modeled together, higher ARTS load accounted for lower levels of global cognition, episodic memory, semantic memory, and perceptual speed, whereas higher infarct load accounted for lower levels of working memory. There were no associations with rate of cognitive change.

Discussion: Both arteriolosclerosis and ischemic infarcts impact the cognitive health of older Black adults, but arteriolosclerosis affects cognition more broadly and offers promise as an in vivo biomarker of dementia risk.

Highlights: Older Black adults are at risk of cerebral small vessel disease (CSVD) and dementia. Examined magnetic resonance imaging-derived measure of arteriolosclerosis (ARTS), infarcts, and cognition. ARTS load was widely associated with lower cognition after adjusting for infarct load. Infarct load was specifically associated with lower complex attention. More within-Black in vivo studies of CSVD subtypes and cognition are needed.

Keywords: African American; aging; cerebral small vessel disease; cognition; ischemic infarct; neuroimaging; older Black adult.

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Conflict of interest statement

The authors declare no conflicts of interest. Author disclosures are available in the Supporting information.

Figures

FIGURE 1
FIGURE 1
Sample derivation.
FIGURE 2
FIGURE 2
ARTS takes as input raw MRI data (DICOM or NIfTI format) and generates a score linked to the likelihood a person suffers from arteriolosclerosis. ARTS is fully automated. All image processing (eg, bias field correction, undistortion, brain segmentation, calculation of diffusion tensors, image registration, segmentation of white matter hyperintensities, and other steps) is conducted automatically by ARTS, and the results of image processing are provided to the user for quality checks.
FIGURE 3
FIGURE 3
ARTS score distribution.
See this image and copyright information in PMC

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