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Abstract
Objective To investigate the cognitive profile of healthy individuals with increased Cardiovascular Risk Factors, Aging and Dementia (CAIDE) dementia risk score and to explore whether this association is related to vascular burden and CSF biomarkers of amyloidosis and neurodegeneration.
Method Cognitively normal participants (mean age 57.6 years) from the Gipuzkoa Alzheimer Project study were classified as having high risk (HR; n = 82) or low risk (LR; n = 293) for dementia according to a CAIDE score cutoff of 9. Cognitive composites were compared between groups. We explored using generalized linear models the role of APOE genotype, MRI white matter hyperintensities (WMH), and CSF (n = 218) levels of β-amyloid1-42 (Aβ1-42), total tau (t-tau), and phosphorylated tau (p-tau) in the association between CAIDE score and cognition.
Results HR participants obtained lower scores on executive function (EF) (p = 0.001) and visual perception and construction (VPC) (p < 0.001) composites. EF composite was associated with CAIDE score × p-tau (p = 0.001), CAIDE score × t-tau (p = 0.001), and WMH (p = 0.003). VPC composite was associated with APOE (p = 0.001), Aβ1–42 (p = 0.004), the interaction APOE × Aβ1–42 (p = 0.003), and WMH (p = 0.004). Performance on global memory was associated with Aβ1–42 (p = 0.006), APOE (p = 0.008), and their interaction (p = 0.006). Analyses were adjusted for age, education, sex, premorbid intelligence, and stress.
Conclusion Healthy participants at increased dementia risk based on CAIDE scores show lower performance in EF and VPC. This difference is related to APOE, WMH, and Alzheimer biomarkers.
Glossary
- Aβ=
- β-amyloid;
- AD=
- Alzheimer disease;
- CAIDE=
- Cardiovascular Risk Factors, Aging and Dementia;
- CDR=
- Clinical Dementia Rating;
- EFc=
- executive function composite;
- FH=
- family history;
- GAP=
- Gipuzkoa Alzheimer Project;
- GLM=
- generalized linear model;
- GMc=
- global memory composite;
- HR=
- high risk;
- JLO=
- Judgment of Line Orientation;
- LR=
- low risk;
- PSQ=
- Perceived Stress Questionnaire;
- p-tau=
- phosphorylated tau;
- RCF=
- Rey Complex Figure;
- t-tau=
- total tau;
- VPCc=
- visual perception and construction composite;
- WAIS-III=
- Wechsler Adult Intelligence Scale, 3rd edition;
- WMH=
- white matter hyperintensities
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received January 15, 2018.
- Accepted in final form April 11, 2018.
- © 2018 American Academy of Neurology
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