Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Vascular Risk Linked with Cognitive Decline

JAMA Neurology; ePub 2018 May 21; Rabin, et al

Vascular risk was associated with prospective cognitive decline in clinically normal older adults, both alone and synergistically with β-amyloid (Aβ) burden, according to a recent study. Furthermore, vascular risk may complement imaging biomarkers in assessing risk of prospective cognitive decline in preclinical Alzheimer disease. In this longitudinal observational study, researchers examined clinically normal older adults from the Harvard Aging Brain Study (n=223, 130 [58.3%] women, mean [SD] age 73.7 [6.0] years, and mean [SD] follow-up time 3.7 [1.2] years). Participants were required to have baseline imaging data (FDG-PET, Aβ-PET, and MRI), baseline medical data to quantify vascular risk, and at least 1 follow-up neuropsychological visit. They found:

  • Faster cognitive decline was associated with both a higher Framingham Heart Study-Cardiovascular Disease (FHS-CVD) risk score (β = −0.064) and higher Aβ burden (β = −0.058).
  • The interaction of the FHS-CVD risk score and Aβ burden with time was significant (β = −0.040), suggesting a synergistic effect.
  • The FHS-CVD risk score remained robustly associated with prospective cognitive decline (β = −0.055), even after adjustment for Aβ burden, hippocampal volume, F-18 labeled positron emission tomography (FDG-PET) uptake, and white matter hyperintensities.

Rabin JS, Schultz AP, Hedden T, et al. Interactive associations of vascular risk and β-amyloid burden with cognitive decline in clinically normal elderly individuals. Findings from the Harvard Aging Brain Study. [Published online ahead print May 21, 2018]. JAMA Neurology. doi:10.1001/jamaneurol.2018.1123.

This Week's Must Reads

Recurrent Stroke Risk Higher for Blacks than Whites, Neurology; ePub 2018 Oct 3; Albright, Huang, et al

Sleep Duration/Stroke Link Differs by Race and Sex, Neurology; ePub 2018 Oct 3; Petrov, Howard, et al

Intracerebral Hemorrhage Survivors’ Outcomes Studied, J Stroke Cerebrovasc Dis; ePub 2018 Sep 28; Griauzde, et al

Probable OSA Common in Refractory Epilepsy, Epilepsia; ePub 2018 Sep 24; McCarter, et al

FDA Approves Tiglutik for Treatment of ALS, ITF Pharma news release; 2018 Sep 6

Must Reads in Alzheimer's & Cognition

Study Replicates MRI Measure of AD Pathologies, Neurology; ePub 2018 Sep 14; Brickman, et al

Behavioral Activation May Cut Dementia Disparity, JAMA Neurology; ePub 2018 Sep 10; Rovner, et al

Prevalence and Incidence of AD Dementia Examined, Alzheimers Dement; ePub 2018 Sep 6; Rajan, et al

Link Found Between Ophthalmic Conditions, AD Risk, Alzheimers Dement; ePub 2018 Aug 8; Lee, et al

Spatial Heterogeneity of White Matter Lesions , Neurology; ePub 2018 Aug 3; Habes, et al