1. White matter hyperintensities and cognition across different Alzheimer's biomarker profiles
- Author
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Lam, Sharon, Lipton, Richard B, Harvey, Danielle J, Zammit, Andrea R, Ezzati, Ali, and Initiative, Alzheimer's Disease Neuroimaging
- Subjects
Health Services and Systems ,Health Sciences ,Prevention ,Basic Behavioral and Social Science ,Alzheimer's Disease including Alzheimer's Disease Related Dementias (AD/ADRD) ,Aging ,Vascular Cognitive Impairment/Dementia ,Alzheimer's Disease ,Brain Disorders ,Behavioral and Social Science ,Dementia ,Cerebrovascular ,Clinical Research ,Neurosciences ,Neurodegenerative ,Alzheimer's Disease Related Dementias (ADRD) ,Acquired Cognitive Impairment ,2.1 Biological and endogenous factors ,Neurological ,Aged ,Aged ,80 and over ,Alzheimer Disease ,Biomarkers ,Cognition ,Cognitive Dysfunction ,Cross-Sectional Studies ,Executive Function ,Female ,Humans ,Leukoaraiosis ,Linear Models ,Male ,Memory ,Memory Disorders ,Neuroimaging ,Vascular Diseases ,White Matter ,Alzheimer&apos ,s disease pathology ,AT(N) research framework ,cognitive decline ,white matter hyperintensities ,Alzheimer's Disease Neuroimaging Initiative ,Alzheimer's disease pathology ,Medical and Health Sciences ,Geriatrics ,Biomedical and clinical sciences ,Health sciences ,Psychology - Abstract
Background/objectivesTo examine the association between white matter hyperintensities (WMH) and cognitive domains such as memory and executive function (EF) across different clinical and biomarker categories of Alzheimer's disease (AD).DesignCross-sectional study.SettingAlzheimer's Disease Neuroimaging Initiative.ParticipantsA total of 216 cognitively normal (CN) participants and 407 participants with mild cognitive impairment (MCI) from the Alzheimer's Disease Neuroimaging Initiative (ADNI) at baseline.MeasurementsBased on the 2018 research framework, participants were classified using AT(N) (amyloid-β deposition [A], pathologic tau [T], and neurodegeneration [(N)]) biomarkers into one of three categories: biomarker negative [A - T- (N)-], amyloid negative but other biomarker positive [A - T ± (N)+ or A - T + (N)±] or amyloid positive [A + T ± (N)±]. Linear regression models were then used to examine the association between WMH and memory composite scores and EF composite scores.ResultsHigher WMH burden was associated with worse EF in both CN and MCI subgroups while a significant association between WMH and memory was only found in the MCI subgroup. Furthermore, WMH was associated with EF in the group with A - T ± (N)+ or A - T + (N)± biomarker category, but not for A - T - (N)- (normal biomarker) and A + T ± (N) ± (AD pathology). The association between higher WMH and worse memory was independent of amyloid levels in individuals with MCI with evidence of AD pathology.ConclusionVascular disease, as indexed by WMH, independent of AD pathology affects cognitive function in both CN and MCI subgroups. Future studies using the AT(N) research framework should consider white matter lesions as a key biomarker contributing to the clinical presentation of AD.
- Published
- 2021