Jonathan Naftali, Amir Glik, Ruth Eliahou, Gil D Rabninovici, Howar J Rosen, Fanny Elahi, Felix Benninger, Ilan Goldberg, Eitan Auriel, Ophir Keret
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引用次数: 0
Abstract
BACKGROUND
This study assessed the impact of cerebral small vessel disease (CSVD) on cognition in individuals with early-onset (EO; <65 years) and late-onset (LO; ≥65 years) cognitive complaints.
METHODS
Participants underwent prospective evaluations including cognitive testing, hyperphosphorylated tau-217 (p-tau217) and neurofilament-light-chain (NfL), and magnetic resonance imaging (MRI). Each CSVD marker was modeled for interaction with group age on results on cognitive outcomes: Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory Questionnaire (NPI-Q), and Clinical Dementia Rating (CDR) scale plus National Alzheimer's Coordinating Center–Frontotemporal Lobar Degeneration module (NACC-FTLD).
RESULTS
Altogether, 168 patients (91 EO) were included. white matter hyperintensity (WMH) volume was associated with worse CDR+NACC-FTLD in EO (β = 17.8, p = 0.013), remaining significant after adjusting for p-tau217 and NfL, but not gray matter atrophy. Lacunes were associated with worse CDR plus NACC-FTLD in EO (β = 4.3, p = 0.011), with age-dependent associations with MoCA, MMSE, CDR + NACC-FTLD, and NPI-Q (p < 0.01).
DISCUSSION
CSVD markers, although less prevalent in EO, had greater clinical impact. These findings highlight an increased vulnerability to vascular pathology in EO patients and the importance of early detection.
Highlights
Cerebral small vessel disease (CSVD) markers were more impactful in early-onset than late-onset dementia.
White matter hyperintensity (WMH) volume predicted functional decline in early onset, independent of neurodegeneration.
Lacunes showed age-dependent effects on multiple cognitive outcomes.
Findings support early detection of CSVD in younger individuals with dementia.
期刊介绍：
Alzheimer's & Dementia is a peer-reviewed journal that aims to bridge knowledge gaps in dementia research by covering the entire spectrum, from basic science to clinical trials to social and behavioral investigations. It provides a platform for rapid communication of new findings and ideas, optimal translation of research into practical applications, increasing knowledge across diverse disciplines for early detection, diagnosis, and intervention, and identifying promising new research directions. In July 2008, Alzheimer's & Dementia was accepted for indexing by MEDLINE, recognizing its scientific merit and contribution to Alzheimer's research.
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