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Ecay-Torres M, Estanga A, Tainta M, Izagirre A, Garcia-Sebastian M, Villanua J, Clerigue M, Iriondo A, Urreta I, Arrospide A, Díaz-Mardomingo C, Kivipelto M, Martinez-Lage P. Increased CAIDE dementia risk, cognition, CSF biomarkers, and vascular burden in healthy adults. Neurology 2018; 91:e217-e226. [PMID: 29898969 DOI: 10.1212/wnl.0000000000005824] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/11/2018] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To investigate the cognitive profile of healthy individuals with increased Cardiovascular Risk Factors, Aging and Dementia (CAIDE) dementia risk score and to explore whether this association is related to vascular burden and CSF biomarkers of amyloidosis and neurodegeneration. METHOD Cognitively normal participants (mean age 57.6 years) from the Gipuzkoa Alzheimer Project study were classified as having high risk (HR; n = 82) or low risk (LR; n = 293) for dementia according to a CAIDE score cutoff of 9. Cognitive composites were compared between groups. We explored using generalized linear models the role of APOE genotype, MRI white matter hyperintensities (WMH), and CSF (n = 218) levels of β-amyloid1-42 (Aβ1-42), total tau (t-tau), and phosphorylated tau (p-tau) in the association between CAIDE score and cognition. RESULTS HR participants obtained lower scores on executive function (EF) (p = 0.001) and visual perception and construction (VPC) (p < 0.001) composites. EF composite was associated with CAIDE score × p-tau (p = 0.001), CAIDE score × t-tau (p = 0.001), and WMH (p = 0.003). VPC composite was associated with APOE (p = 0.001), Aβ1-42 (p = 0.004), the interaction APOE × Aβ1-42 (p = 0.003), and WMH (p = 0.004). Performance on global memory was associated with Aβ1-42 (p = 0.006), APOE (p = 0.008), and their interaction (p = 0.006). Analyses were adjusted for age, education, sex, premorbid intelligence, and stress. CONCLUSION Healthy participants at increased dementia risk based on CAIDE scores show lower performance in EF and VPC. This difference is related to APOE, WMH, and Alzheimer biomarkers.
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Affiliation(s)
- Mirian Ecay-Torres
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Ainara Estanga
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Mikel Tainta
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Andrea Izagirre
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Maite Garcia-Sebastian
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Jorge Villanua
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Montserrat Clerigue
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Ane Iriondo
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Iratxe Urreta
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Arantzazu Arrospide
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Carmen Díaz-Mardomingo
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Miia Kivipelto
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden
| | - Pablo Martinez-Lage
- From the Departments of Neurology (M.E.-T., A.E., M.T., A.I., M.C., A.I., P.M.-L.) and Neuroimaging (M.G.-S., J.V.), Center for Research and Advanced Therapies, CITA-Alzheimer Foundation, San Sebastian; National University of Distance Education (M.E.-T.), Madrid; Mendaro Hospital (M.T.); Donostia Unit (J.V.), Osatek SA, Donostia University Hospital; Department of Clinical Epidemiology (I.U.), CIBER-ESP, Biodonostia Health Research Institute, San Sebastian; Gipuzkoa Primary Care-Integrated Health Care Organizations Research Unit (A.A.), Alto Deba Integrated Health Care Organisation; Health Services Research on Chronic Patients Network (A.A.), Arrasate; Donostia (A.A.), Biodonostia Health Research Institute, San Sebastian; Departamento de Psicología Básica I (C.D.-M.), Facultad de Psicología, National University of Distance Education, Madrid, Spain; and Center for Alzheimer Research (M.K.), Karolinska University Hospital, Karolinska Institutet, Huddinge, Sweden.
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