Subgroup of ADNI normal controls characterized by atrophy and cognitive decline associated with vascular damage

Psychol Aging. 2013 Mar;28(1):191-201. doi: 10.1037/a0031063.

Abstract

Previous work examining Alzheimer's Disease Neuroimaging Initiative (ADNI) normal controls using cluster analysis identified a subgroup characterized by substantial brain atrophy and white matter hyperintensities (WMH). We hypothesized that these effects could be related to vascular damage. Fifty-three individuals in the suspected vascular cluster (Normal 2) were compared with 31 individuals from the cluster characterized as healthy/typical (Normal 1) on a variety of outcomes, including magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) biomarkers, vascular risk factors and outcomes, cognitive trajectory, and medications for vascular conditions. Normal 2 was significantly older but did not differ on ApoE4+ prevalence. Normal 2 differed significantly from Normal 1 on all MRI measures but not on Amyloid-Beta1-42 or total tau protein. Normal 2 had significantly higher body mass index (BMI), Hachinksi score, and creatinine levels, and took significantly more medications for vascular conditions. Normal 2 had marginally significantly higher triglycerides and blood glucose. Normal 2 had a worse cognitive trajectory on the Rey's Auditory Verbal Learning Test (RAVLT) 30-min delay test and the Functional Activity Questionnaire (FAQ). Cerebral atrophy associated with multiple vascular risks is common among cognitively normal individuals, forming a distinct subgroup with significantly increased cognitive decline. Further studies are needed to determine the clinical impact of these findings.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aging / pathology*
  • Aging / physiology
  • Alzheimer Disease / blood
  • Alzheimer Disease / cerebrospinal fluid
  • Alzheimer Disease / pathology
  • Atrophy
  • Biomarkers / blood
  • Biomarkers / cerebrospinal fluid
  • Biomarkers / metabolism
  • Brain / pathology*
  • Brain / physiopathology
  • Cerebrovascular Disorders / complications
  • Cerebrovascular Disorders / pathology*
  • Cerebrovascular Disorders / physiopathology
  • Cognition Disorders / etiology
  • Cognition Disorders / pathology*
  • Cognition Disorders / physiopathology
  • Female
  • Humans
  • Male
  • Registries

Substances

  • Biomarkers