Amyloid, cerebrovascular disease, and neurodegeneration biomarkers are associated with cognitive trajectories in a racially and ethnically diverse, community-based sample

• Published in: Neurobiology of aging 2022-09, Vol.117, p.83-96
• Main Authors: Lao, Patrick J., Boehme, Amelia K., Morales, Clarissa, Laing, Krystal K., Chesebro, Anthony, Igwe, Kay C., Gutierrez, Jose, Gu, Yian, Stern, Yaakov, Schupf, Nicole, Manly, Jennifer J., Mayeux, Richard, Brickman, Adam M.
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Alzheimer Disease - diagnosis; Alzheimer's disease; Amyloid; Amyloidosis; Biomarkers; Cerebrovascular disease; Cerebrovascular Disorders; Cognition; Cognitive decline; Cognitive Dysfunction - diagnosis; Female; Humans; Infarction; Magnetic Resonance Imaging; Male; Neuroimaging; Neuropsychological Tests; Prospective Studies; Race/Ethnicity
• ISSN: 0197-4580; 1558-1497
• DOI: 10.1016/j.neurobiolaging.2022.05.004

•Greater amyloid was associated with faster memory decline in older adults.•Greater amyloid was associated with faster non–memory decline in older Non-Hispanic Black and Hispanic adults.•White matter hyperintensity (WMH) was greater in older Non-Hispanic adults and associated with faster multidomain cognitive decline.•Infarcts were associated with faster executive function decline in older Non-Hispanic white adults.•Amyloid-vascular-neurodegeneration (AV(N)) models are relevant for Alzheimer's disease in all groups, particularly when considering social determinants of health. We characterized the additive contribution of cerebrovascular biomarkers to amyloid and neurodegeneration biomarkers (AV(N)) when modeling prospective, longitudinal cognitive trajectories within 3 major racial/ethnic groups. Participants (n = 172; age = 69–96 years; 62% women; 31%/49%/20% Non–Hispanic White/Non–Hispanic Black/Hispanic) from the Washington Heights-Inwood Columbia Aging Project were assessed for amyloid (Florbetaben PET), neurodegeneration (cortical thickness, hippocampal volume), and cerebrovascular disease (white matter hyperintensity (WMH), infarcts). Neuropsychological assessments occurred every 2.3 ± 0.6 years for up to 6 visits (follow-up time: 4.2 ± 3.2 years). Linear mixed-effects models were stratified by race/ethnicity groups. Higher amyloid was associated with faster memory decline in all 3 racial/ethnic groups, but was related to faster cognitive decline beyond memory in minoritized racial/ethnic groups. Higher WMH was associated with faster language, processing speed/executive function, and visuospatial ability decline in Non–Hispanic Black participants, while infarcts were associated with faster processing speed/executive function decline in Non–Hispanic White participants. Complementary information from AD, neurodegenerative, and cerebrovascular biomarkers explain decline in multiple cognitive domains, which may differ within each racial/ethnic group. Importantly, treatment strategies exist to minimize vascular contributions to cognitive decline. [Display omitted]