Journal
ANNALS OF NEUROLOGY
Volume 84, Issue 5, Pages 705-716Publisher
WILEY
DOI: 10.1002/ana.25346
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Funding
- National Institute of Neurological Disorders and Stroke (NINDS)
- National Institute on Aging (NIA) [R01 NS097495, U01 AG06786, R01 AG56366, P50 AG16574/P1, P50 AG16574, R01 AG11378, R01 AG041851]
- GHR Foundation
- Millis Family
- Alexander Family Alzheimer's Disease Research Professorship of the Mayo Foundation
- Liston Award
- Elsie and Marvin Dekelboum Family Foundation
- Schuler Foundation
- Opus Building NIH grant [C06 RR018898]
- Rochester Epidemiology Project [R01 AG034676]
- NATIONAL CENTER FOR RESEARCH RESOURCES [C06RR018898] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE OF NEUROLOGICAL DISORDERS AND STROKE [R01NS097495, U01NS100620] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON AGING [RF1AG057547, R01AG041851, R01AG034676, U01AG006786, P50AG016574, R01AG056366, R01AG011378] Funding Source: NIH RePORTER
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Objective Methods Recent availability of amyloid and tau positron emission tomography (PET) has provided us with a unique opportunity to measure the association of systemic vascular health with brain health after accounting for the impact of Alzheimer disease (AD) pathologies. We wanted to quantify early cerebrovascular health-related magnetic resonance imaging brain measures (structure, perfusion, microstructural integrity) and evaluate their utility as a biomarker for cerebrovascular health. We used 2 independent samples (discovery, n = 390; validation, n = 1,035) of individuals, aged >= 60 years, along the cognitive continuum with imaging from the population-based sample of Mayo Clinic Study of Aging. We ascertained vascular health by summing up recently existing cardiovascular and metabolic conditions (CMC) from health care records (hypertension, hyperlipidemia, cardiac arrhythmias, coronary artery disease, congestive heart failure, diabetes mellitus, and stroke). Using multiple regression models, we quantified associations between CMC and brain health after accounting for age, sex, education/occupation, and AD burden (from amyloid and tau PET). Results Interpretation Systemic vascular health was associated with medial temporal lobe thinning, widespread cerebral hypoperfusion, and loss of microstructural integrity in several white matter tracts including the corpus callosum and fornix. Further investigations suggested that microstructural integrity of the genu of the corpus callosum was suitable for assessing prodromal cerebrovascular health, had similar distributions in the discovery and independent validation datasets, and predicted cognitive performance above and beyond amyloid deposition. Systemic vascular health has significant impact on brain structure and function. Quantifying prodromal cerebrovascular health-related brain measures that are independent of AD pathology-related changes has great utility for cognitive aging. Ann Neurol 2018;84:713-724
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