Rabinovici GD, Alkalay A, Marchant NL, DeCarli C, Mungas DM, Chui HC, Reed BR, Jagust WJ.
Contribution of amyloid and cerebrovascular disease to cognitive impairment in individuals with high vascular risk.
Human Amyloid Imaging 2010 Meeting Abstracts. 2010 April 9;
Objective: To evaluate the relationship of amyloid and cerebrovascular disease (CVD) to cognitive state in a
population with high vascular risk.
Methods: Subjects enrolled in two vascular-focused studies of cognition underwent PIB-PET and MRI (n=23,
mean age 79.8±7.8 years, 91% with vascular risk factors). PIB DVR images (Logan, cerebellar reference) were
classified as positive (PIB+) or negative (PIB-) based on visual reads and MRI scans were rated for the presence of
infarcts, all blinded to clinical data. Subjects were classified as having cerebrovascular disease (CVD+) if there was
a clinical history of stroke/TIA or an infarct on MRI. Patients with a CDR≥0.5 were considered cognitively impaired
(n=14/23, median CDR=0.5).
Results: 10/23 subjects had PIB+ scans (mean PIB Index 1.31±0.30, versus 0.95±0.05 in PIB- scans, pConclusions: In this small, mildly impaired, elderly cohort enriched for vascular disease, CVD was more strongly
linked to cognition than was amyloid. CVD is often viewed as a secondary factor in cognitive impairment, but this
data suggests it is not infrequently the primary cause of mild impairment. Further studies are needed to determine
the relative contributions of amyloid and CVD to changes in cognition and brain structure, and function.
Potential conflicts of interest: Nothing to report.
Funding: Supported by the National Institute on Aging P01-AG12435, R01-AG031563, R01-AG10129,
K23-AG031861; Alzheimer’s Association ZEN-08-87090.