The contribution of vascular risk factors in neurodegenerative disorders: From mild cognitive impairment to Alzheimer's disease
Journal
Alzheimer's Research and Therapy
Journal Volume
12
Journal Issue
1
Pages
91
Date Issued
2020
Author(s)
Abstract
Background: Optimization of vascular risk factor control is emerging as an alternative approach to improve cognitive outcomes in Alzheimer's disease, although its efficacy is still under debate. We aimed to investigate the contribution of vascular risk factors on Alzheimer's biomarkers and conversion rate to dementia in subjects with mild cognitive impairment (MCI) with low cerebral small vessel disease burden. Methods: Two hundred ninety-five newly diagnosed MCI subjects were enrolled from March 2005 to May 2017 for a cross-sectional assessment of vascular risk factors and Alzheimer's plasma and imaging biomarkers, followed by a cognitive outcome assessment 24 months after enrollment. The association between vascular risk factors and Alzheimer's biomarkers were tested using multivariable linear regression models adjusted with age, gender, education, and APOE ?4 allele. The association between vascular risk factors and conversion to dementia was tested using multivariable logistic regression models adjusted with age, gender, education, and baseline Mini-Mental State Examination (MMSE) score. Results: At baseline, higher low-density lipoprotein (LDL) cholesterol level was associated with more advanced plasma biomarkers, including Aβ42/Aβ40 ratio (P = 0.012) and tau level (P = 0.001). A history of hypertension was associated with more advanced white matter hyperintensity (P = 0.011), while statin therapy for dyslipidemia was associated with less advanced white matter hyperintensity (P = 0.002). At 24 months, individual vascular risk factor was not significantly associated with cognitive outcome. By contrast, statin therapy for dyslipidemia was associated with reduced conversion to dementia (adjusted OR = 0.191, 95% CI = 0.062~0.586, P = 0.004). Conclusions: For MCI subjects, dyslipidemia may contribute to AD-related neurodegeneration while hypertension may contribute to vascular pathology. The association between statin therapy for dyslipidemia and reduced conversion to dementia supports further interventional study to evaluate the potential beneficial effect of statin in MCI subjects. ? 2020 The Author(s).
SDGs
Other Subjects
amyloid beta protein[1-40]; amyloid beta protein[1-42]; apolipoprotein E; high density lipoprotein cholesterol; hydroxymethylglutaryl coenzyme A reductase inhibitor; low density lipoprotein cholesterol; biological marker; aged; Alzheimer disease; Article; cerebrovascular disease; cognition assessment; cohort analysis; controlled study; cross-sectional study; degenerative disease; demography; disease association; disease burden; dyslipidemia; educational status; female; human; major clinical study; male; mild cognitive impairment; Mini Mental State Examination; priority journal; risk factor; Alzheimer disease; cognitive defect; disease exacerbation; genetics; risk factor; Alzheimer Disease; Biomarkers; Cognitive Dysfunction; Cross-Sectional Studies; Disease Progression; Humans; Risk Factors
Type
journal article