Cerebral amyloid angiopathy pathology and cognitive domains in older persons
Objective To examine the relation of cerebral amyloid angiopathy (CAA) to cognitive domains in older community‐dwelling persons with and without dementia. Methods Subjects were 404 persons in the Religious Orders Study, a cohort study of aging, who underwent annual clinical evaluations, including 19...
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| Published in | Annals of neurology Vol. 69; no. 2; pp. 320 - 327 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Hoboken
Wiley Subscription Services, Inc., A Wiley Company
01.02.2011
Wiley-Liss Wiley Subscription Services, Inc |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0364-5134 1531-8249 1531-8249 |
| DOI | 10.1002/ana.22112 |
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| Abstract | Objective
To examine the relation of cerebral amyloid angiopathy (CAA) to cognitive domains in older community‐dwelling persons with and without dementia.
Methods
Subjects were 404 persons in the Religious Orders Study, a cohort study of aging, who underwent annual clinical evaluations, including 19 neuropsychological tests from which 5 cognitive domain and global summary scores were derived, and brain autopsy at time‐of‐death (mean age‐at‐death 86). Using amyloid‐β immunostaining, CAA severity was graded in 5 regions (midfrontal, inferior temporal, angular, calcarine, and hippocampal cortices), as 0 = none, 1 = mild, 2 = moderate, 3 = severe, and 4 = very severe. Because severity was related across regions (all rs > 0.63), and almost all persons had some CAA, we averaged regional CAA scores and created class variable predictors for no‐to‐minimal (<0.5), mild‐to‐moderate (0.5‐2.5) and moderate‐to‐very severe CAA (>2.5).
Results
CAA was very common (84.9%; 94 had no‐to‐minimal, 233 mild‐to‐moderate, and 76 moderate‐to‐very severe disease) and was related to AD pathology (rs = 0.68). In linear regression analyses controlling for age, sex, education, AD pathology, infarcts, and Lewy bodies, moderate‐to‐very severe CAA was associated with lower perceptual speed (p = 0.012) and episodic memory (p = 0.047), but not semantic memory, working memory, visuospatial skills, or a composite of all cognitive measures. No associations of mild‐to‐moderate CAA with cognition were found. Dementia did not modify these findings.
Interpretation
CAA pathology is very common in older community‐dwelling persons and is associated with AD pathology. Moderate‐to‐very severe CAA, but not mild‐to‐moderate CAA, is associated with lower performance in specific cognitive domains, most notably perceptual speed, separately from the effect of AD pathology. ANN NEUROL 2011 |
|---|---|
| AbstractList | Objective
To examine the relation of cerebral amyloid angiopathy (CAA) to cognitive domains in older community‐dwelling persons with and without dementia.
Methods
Subjects were 404 persons in the Religious Orders Study, a cohort study of aging, who underwent annual clinical evaluations, including 19 neuropsychological tests from which 5 cognitive domain and global summary scores were derived, and brain autopsy at time‐of‐death (mean age‐at‐death 86). Using amyloid‐β immunostaining, CAA severity was graded in 5 regions (midfrontal, inferior temporal, angular, calcarine, and hippocampal cortices), as 0 = none, 1 = mild, 2 = moderate, 3 = severe, and 4 = very severe. Because severity was related across regions (all rs > 0.63), and almost all persons had some CAA, we averaged regional CAA scores and created class variable predictors for no‐to‐minimal (<0.5), mild‐to‐moderate (0.5‐2.5) and moderate‐to‐very severe CAA (>2.5).
Results
CAA was very common (84.9%; 94 had no‐to‐minimal, 233 mild‐to‐moderate, and 76 moderate‐to‐very severe disease) and was related to AD pathology (rs = 0.68). In linear regression analyses controlling for age, sex, education, AD pathology, infarcts, and Lewy bodies, moderate‐to‐very severe CAA was associated with lower perceptual speed (p = 0.012) and episodic memory (p = 0.047), but not semantic memory, working memory, visuospatial skills, or a composite of all cognitive measures. No associations of mild‐to‐moderate CAA with cognition were found. Dementia did not modify these findings.
Interpretation
CAA pathology is very common in older community‐dwelling persons and is associated with AD pathology. Moderate‐to‐very severe CAA, but not mild‐to‐moderate CAA, is associated with lower performance in specific cognitive domains, most notably perceptual speed, separately from the effect of AD pathology. ANN NEUROL 2011 Objective To examine the relation of cerebral amyloid angiopathy (CAA) to cognitive domains in older community-dwelling persons with and without dementia. Methods Subjects were 404 persons in the Religious Orders Study, a cohort study of aging, who underwent annual clinical evaluations, including 19 neuropsychological tests from which 5 cognitive domain and global summary scores were derived, and brain autopsy at time-of-death (mean age-at-death 86). Using amyloid-[beta] immunostaining, CAA severity was graded in 5 regions (midfrontal, inferior temporal, angular, calcarine, and hippocampal cortices), as 0 = none, 1 = mild, 2 = moderate, 3 = severe, and 4 = very severe. Because severity was related across regions (all rs > 0.63), and almost all persons had some CAA, we averaged regional CAA scores and created class variable predictors for no-to-minimal (<0.5), mild-to-moderate (0.5-2.5) and moderate-to-very severe CAA (>2.5). Results CAA was very common (84.9%; 94 had no-to-minimal, 233 mild-to-moderate, and 76 moderate-to-very severe disease) and was related to AD pathology (rs = 0.68). In linear regression analyses controlling for age, sex, education, AD pathology, infarcts, and Lewy bodies, moderate-to-very severe CAA was associated with lower perceptual speed (p = 0.012) and episodic memory (p = 0.047), but not semantic memory, working memory, visuospatial skills, or a composite of all cognitive measures. No associations of mild-to-moderate CAA with cognition were found. Dementia did not modify these findings. Interpretation CAA pathology is very common in older community-dwelling persons and is associated with AD pathology. Moderate-to-very severe CAA, but not mild-to-moderate CAA, is associated with lower performance in specific cognitive domains, most notably perceptual speed, separately from the effect of AD pathology. ANN NEUROL 2011 [PUBLICATION ABSTRACT] Objective To examine the relation of cerebral amyloid angiopathy (CAA) to cognitive domains in older community-dwelling persons with and without dementia. Methods Subjects were 404 persons in the Religious Orders Study, a cohort study of aging, who underwent annual clinical evaluations, including 19 neuropsychological tests from which 5 cognitive domain and global summary scores were derived, and brain autopsy at time-of-death (mean age-at-death 86). Using amyloid- Delta *b immunostaining, CAA severity was graded in 5 regions (midfrontal, inferior temporal, angular, calcarine, and hippocampal cortices), as 0 = none, 1 = mild, 2 = moderate, 3 = severe, and 4 = very severe. Because severity was related across regions (all rs > 0.63), and almost all persons had some CAA, we averaged regional CAA scores and created class variable predictors for no-to-minimal (<0.5), mild-to-moderate (0.5-2.5) and moderate-to-very severe CAA (>2.5). Results CAA was very common (84.9%; 94 had no-to-minimal, 233 mild-to-moderate, and 76 moderate-to-very severe disease) and was related to AD pathology (rs = 0.68). In linear regression analyses controlling for age, sex, education, AD pathology, infarcts, and Lewy bodies, moderate-to-very severe CAA was associated with lower perceptual speed (p = 0.012) and episodic memory (p = 0.047), but not semantic memory, working memory, visuospatial skills, or a composite of all cognitive measures. No associations of mild-to-moderate CAA with cognition were found. Dementia did not modify these findings. Interpretation CAA pathology is very common in older community-dwelling persons and is associated with AD pathology. Moderate-to-very severe CAA, but not mild-to-moderate CAA, is associated with lower performance in specific cognitive domains, most notably perceptual speed, separately from the effect of AD pathology. ANN NEUROL 2011 To examine the relation of cerebral amyloid angiopathy (CAA) to cognitive domains in older community-dwelling persons with and without dementia. Subjects were 404 persons in the Religious Orders Study, a cohort study of aging, who underwent annual clinical evaluations, including 19 neuropsychological tests from which 5 cognitive domain and global summary scores were derived, and brain autopsy at time-of-death (mean age-at-death 86). Using amyloid-β immunostaining, CAA severity was graded in 5 regions (midfrontal, inferior temporal, angular, calcarine, and hippocampal cortices), as 0 = none, 1 = mild, 2 = moderate, 3 = severe, and 4 = very severe. Because severity was related across regions (all r(s) > 0.63), and almost all persons had some CAA, we averaged regional CAA scores and created class variable predictors for no-to-minimal (<0.5), mild-to-moderate (0.5-2.5) and moderate-to-very severe CAA (>2.5). CAA was very common (84.9%; 94 had no-to-minimal, 233 mild-to-moderate, and 76 moderate-to-very severe disease) and was related to AD pathology (r(s) = 0.68). In linear regression analyses controlling for age, sex, education, AD pathology, infarcts, and Lewy bodies, moderate-to-very severe CAA was associated with lower perceptual speed (p = 0.012) and episodic memory (p = 0.047), but not semantic memory, working memory, visuospatial skills, or a composite of all cognitive measures. No associations of mild-to-moderate CAA with cognition were found. Dementia did not modify these findings. CAA pathology is very common in older community-dwelling persons and is associated with AD pathology. Moderate-to-very severe CAA, but not mild-to-moderate CAA, is associated with lower performance in specific cognitive domains, most notably perceptual speed, separately from the effect of AD pathology. To examine the relation of cerebral amyloid angiopathy (CAA) to cognitive domains in older community-dwelling persons with and without dementia.OBJECTIVETo examine the relation of cerebral amyloid angiopathy (CAA) to cognitive domains in older community-dwelling persons with and without dementia.Subjects were 404 persons in the Religious Orders Study, a cohort study of aging, who underwent annual clinical evaluations, including 19 neuropsychological tests from which 5 cognitive domain and global summary scores were derived, and brain autopsy at time-of-death (mean age-at-death 86). Using amyloid-β immunostaining, CAA severity was graded in 5 regions (midfrontal, inferior temporal, angular, calcarine, and hippocampal cortices), as 0 = none, 1 = mild, 2 = moderate, 3 = severe, and 4 = very severe. Because severity was related across regions (all r(s) > 0.63), and almost all persons had some CAA, we averaged regional CAA scores and created class variable predictors for no-to-minimal (<0.5), mild-to-moderate (0.5-2.5) and moderate-to-very severe CAA (>2.5).METHODSSubjects were 404 persons in the Religious Orders Study, a cohort study of aging, who underwent annual clinical evaluations, including 19 neuropsychological tests from which 5 cognitive domain and global summary scores were derived, and brain autopsy at time-of-death (mean age-at-death 86). Using amyloid-β immunostaining, CAA severity was graded in 5 regions (midfrontal, inferior temporal, angular, calcarine, and hippocampal cortices), as 0 = none, 1 = mild, 2 = moderate, 3 = severe, and 4 = very severe. Because severity was related across regions (all r(s) > 0.63), and almost all persons had some CAA, we averaged regional CAA scores and created class variable predictors for no-to-minimal (<0.5), mild-to-moderate (0.5-2.5) and moderate-to-very severe CAA (>2.5).CAA was very common (84.9%; 94 had no-to-minimal, 233 mild-to-moderate, and 76 moderate-to-very severe disease) and was related to AD pathology (r(s) = 0.68). In linear regression analyses controlling for age, sex, education, AD pathology, infarcts, and Lewy bodies, moderate-to-very severe CAA was associated with lower perceptual speed (p = 0.012) and episodic memory (p = 0.047), but not semantic memory, working memory, visuospatial skills, or a composite of all cognitive measures. No associations of mild-to-moderate CAA with cognition were found. Dementia did not modify these findings.RESULTSCAA was very common (84.9%; 94 had no-to-minimal, 233 mild-to-moderate, and 76 moderate-to-very severe disease) and was related to AD pathology (r(s) = 0.68). In linear regression analyses controlling for age, sex, education, AD pathology, infarcts, and Lewy bodies, moderate-to-very severe CAA was associated with lower perceptual speed (p = 0.012) and episodic memory (p = 0.047), but not semantic memory, working memory, visuospatial skills, or a composite of all cognitive measures. No associations of mild-to-moderate CAA with cognition were found. Dementia did not modify these findings.CAA pathology is very common in older community-dwelling persons and is associated with AD pathology. Moderate-to-very severe CAA, but not mild-to-moderate CAA, is associated with lower performance in specific cognitive domains, most notably perceptual speed, separately from the effect of AD pathology.INTERPRETATIONCAA pathology is very common in older community-dwelling persons and is associated with AD pathology. Moderate-to-very severe CAA, but not mild-to-moderate CAA, is associated with lower performance in specific cognitive domains, most notably perceptual speed, separately from the effect of AD pathology. |
| Author | Leurgans, Sue E. Schneider, Julie A. Wang, Zhenxin Wilson, Robert S. Arvanitakis, Zoe Bennett, David A. |
| AuthorAffiliation | 4 Department of Pathology, Rush University Medical Center, Chicago, IL 1 Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 3 Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL 2 Department of Neurological Sciences, Rush University Medical Center, Chicago, IL |
| AuthorAffiliation_xml | – name: 1 Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL – name: 3 Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL – name: 2 Department of Neurological Sciences, Rush University Medical Center, Chicago, IL – name: 4 Department of Pathology, Rush University Medical Center, Chicago, IL |
| Author_xml | – sequence: 1 givenname: Zoe surname: Arvanitakis fullname: Arvanitakis, Zoe organization: Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL – sequence: 2 givenname: Sue E. surname: Leurgans fullname: Leurgans, Sue E. organization: Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL – sequence: 3 givenname: Zhenxin surname: Wang fullname: Wang, Zhenxin organization: Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL – sequence: 4 givenname: Robert S. surname: Wilson fullname: Wilson, Robert S. organization: Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL – sequence: 5 givenname: David A. surname: Bennett fullname: Bennett, David A. organization: Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL – sequence: 6 givenname: Julie A. surname: Schneider fullname: Schneider, Julie A. organization: Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL |
| BackLink | http://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=23923176$$DView record in Pascal Francis https://www.ncbi.nlm.nih.gov/pubmed/21387377$$D View this record in MEDLINE/PubMed |
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To examine the relation of cerebral amyloid angiopathy (CAA) to cognitive domains in older community‐dwelling persons with and without dementia.... To examine the relation of cerebral amyloid angiopathy (CAA) to cognitive domains in older community-dwelling persons with and without dementia. Subjects were... Objective To examine the relation of cerebral amyloid angiopathy (CAA) to cognitive domains in older community-dwelling persons with and without dementia.... To examine the relation of cerebral amyloid angiopathy (CAA) to cognitive domains in older community-dwelling persons with and without dementia.OBJECTIVETo... |
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| SubjectTerms | Aging - pathology Amyloid - metabolism Biological and medical sciences Brain - metabolism Brain - pathology Brain - physiopathology Cerebral Amyloid Angiopathy - metabolism Cerebral Amyloid Angiopathy - pathology Cerebral Amyloid Angiopathy - physiopathology Cognition - physiology Cognition Disorders - metabolism Cognition Disorders - pathology Cognition Disorders - physiopathology Dementia - metabolism Dementia - pathology Dementia - physiopathology Humans Linear Models Longitudinal Studies Medical sciences Memory Neurology Neuropsychological Tests Pathology Religious orders Severity of Illness Index Vascular diseases and vascular malformations of the nervous system |
| Title | Cerebral amyloid angiopathy pathology and cognitive domains in older persons |
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