The prevalence of vascular risk factors in different AD biomarker profiles

Alzheimer s & Dementia, vol. 17

Abstract

Abstract Background The relation between vascular risk factors and Alzheimer’s disease (AD) pathophysiology has been gaining an increasing research interest. Our aim was to investigate the prevalence of vascular factors in regard to different AD biomarker profiles in a memory clinic setting. Method We performed a retrospective analysis of patients of two memory clinics (University Hospital Aachen (Germany) and Maastricht University Medical Centre (The Netherlands)) in between 2008 and 2019. We included patients, who were older than 45 years and had data on demographics, vascular risk factors, cerebrospinal fluid (CSF) and brain magnetic resonance imaging (MRI). The individuals were assigned an ATN profile according to Jack et al. (2018), with “A” referring to amyloid‐pathology (CSF Aβ 1‐42/ Aβ 1‐40 ratio or CSF Aβ 1‐42), “T” to tauopathy (CSF phosphorylated Tau) and “N” ‐ neurodegeneration (CSF total Tau and/or medial temporal atrophy (MTA) score). All patients were categorised into normal ATN profile (A‐T‐N‐), non‐AD change (A‐T+N‐, A‐T‐N+, A‐T+N+) and AD‐continuum (A+T‐N‐, A+T+N‐, A+T‐N+, A+T+N+) groups. Result Of the 838 subjects included into the analysis, 53.2% were men; mean age was 68.7 ± 9.7 years. The most common vascular risk factors in the cohort were smoking (60.9%), hypertension (54.6%) and dyslipidemia (37.8%). A higher prevalence in the AD‐continuum group than in the normal ATN and non‐AD‐change groups was found for coronary heart disease (11,9% vs. 4,8% and 9.6% respectively, Pearson χ2 = 9.788, p=.007) and carotid artery stenosis (30.6% vs. 15.8 % and 17.1 % respectively, Pearson χ2 = 22.326, p<.001). Alcohol abuse and smoking were the most prevalent in non‐AD‐change group (alcohol abuse: 23.9% vs. 15.0% and 9.1%, Pearson χ2 = 7.501, p=.024; smoking: 69.4% vs. 60.3% and 52.1%, Pearson χ2 = 7.871, p=.020). Depression was more prevalent in the normal ATN group than in other groups (19.3% vs. 10.8% and 10.1%, Pearson χ2 = 12.930, p=.002). Conclusion Vascular risk factors are very common in memory clinic patients, showing distinct differences between different AD biomarker profiles. This implies the need for controlling vascular factors in memory clinics and urges to further investigate this field to improve the prevention and treatment of dementia.

Authors 9

1. Domantė Kučikienė corresponding Aachen

   RWTH Aachen University · Universitätsklinikum Aachen

   Affiliation as printed

   University Hospital RWTH Aachen Aachen Germany

   University Hospital RWTH Aachen, Aachen, Germany

2. Ana Sofia Costa Aachen

   RWTH Aachen University · Universitätsklinikum Aachen · Jülich Aachen Research Alliance

   Affiliation as printed

   JARA Institute Molecular Neuroscience and Neuroimaging Aachen Germany

   University Hospital RWTH Aachen Aachen Germany

   JARA Institute Molecular Neuroscience and Neuroimaging, Aachen, Germany

   University Hospital RWTH Aachen, Aachen, Germany

3. Leonie C. P. Banning

   Maastricht University

   Affiliation as printed

   Maastricht University Maastricht Netherlands

   Maastricht University, Maastricht, Netherlands

4. Veerle van Gils

   Maastricht University

   Affiliation as printed

   Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University Maastricht Netherlands

   Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands

5. Jörg Bernhard Schulz Aachen

   RWTH Aachen University

   Affiliation as printed

   RWTH Aachen University Aachen Germany

   RWTH Aachen University, Aachen, Germany

6. Inez H.G.B. Ramakers

   Maastricht University

   Affiliation as printed

   Maastricht University Maastricht Netherlands

   School for Mental Health &amp; Neuroscience Maastricht Netherlands

   Maastricht University, Maastricht, Netherlands

   School for Mental Health &amp; Neuroscience Maastricht Netherlands

7. Frans R.J. Verhey

   Maastricht University

   Affiliation as printed

   Maastricht University, Alzheimer Center Limburg, School for Mental Health and Neuroscience Maastricht Netherlands

   Maastricht University, Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht, Netherlands

8. Stephanie J. B. Vos

   Maastricht University

   Affiliation as printed

   Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University Maastricht Netherlands

   Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands

9. Kathrin Reetz Aachen

   RWTH Aachen University · Universitätsklinikum Aachen · Jülich Aachen Research Alliance

   Affiliation as printed

   JARA Institute Molecular Neuroscience and Neuroimaging Aachen Germany

   University Hospital RWTH Aachen Aachen Germany

   JARA Institute Molecular Neuroscience and Neuroimaging, Aachen, Germany

   University Hospital RWTH Aachen, Aachen, Germany