Dror Shir , Jonathan Graff-Radford , Angela J. Fought , Timothy G. Lesnick , Scott A. Przybelski , Maria Vassilaki , Val J. Lowe , David S. Knopman , Mary M. Machulda , Ronald C. Petersen , Clifford R. Jack Jr , Michelle M. Mielke , Prashanthi Vemuri
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引用次数: 0
摘要
导言：老年痴呆症和心血管疾病经常并发，是导致老年认知能力下降的主要原因。我们评估了人口统计学因素、教育和职业所显示的社会经济地位（SES）、血管风险因素以及一系列与心血管疾病（包括白质高密度[WMH]、弥散磁共振成像异常、梗塞和微出血）和注意力缺失症（包括淀粉样蛋白-PET和tau-PET）相关的生物标志物如何共同影响认知功能。结果（1）较高的社会经济地位对认知有保护作用，并通过血管途径进行调节。(2）淀粉样蛋白直接或通过 tau 对认知的影响比淀粉样蛋白通过 WMH 对认知的间接影响大 11 倍。(3) 血管风险对 tau 沉积有显著影响。血管风险和社会经济地位对这些生物标志物的总体影响非常复杂，需要进一步研究。
Complex relationships of socioeconomic status with vascular and Alzheimer’s pathways on cognition
Introduction
AD and CVD, which frequently co-occur, are leading causes of age-related cognitive decline. We assessed how demographic factors, socioeconomic status (SES) as indicated by education and occupation, vascular risk factors, and a range of biomarkers associated with both CVD (including white matter hyperintensities [WMH], diffusion MRI abnormalities, infarctions, and microbleeds) and AD (comprising amyloid-PET and tau-PET) collectively influence cognitive function.
Methods
In this cross-sectional population study, structural equation models were utilized to understand these associations in 449 participants (mean age (SD) = 74.5 (8.4) years; 56% male; 7.5% cognitively impaired).
Results
(1) Higher SES had a protective effect on cognition with mediation through the vascular pathway. (2) The effect of amyloid directly on cognition and through tau was 11-fold larger than the indirect effect of amyloid on cognition through WMH. (3) There is a significant effect of vascular risk on tau deposition.
Discussion
The utilized biomarkers captured the impact of CVD and AD on cognition. The overall effect of vascular risk and SES on these biomarkers are complex and need further investigation.
期刊介绍：
NeuroImage: Clinical, a journal of diseases, disorders and syndromes involving the Nervous System, provides a vehicle for communicating important advances in the study of abnormal structure-function relationships of the human nervous system based on imaging.
The focus of NeuroImage: Clinical is on defining changes to the brain associated with primary neurologic and psychiatric diseases and disorders of the nervous system as well as behavioral syndromes and developmental conditions. The main criterion for judging papers is the extent of scientific advancement in the understanding of the pathophysiologic mechanisms of diseases and disorders, in identification of functional models that link clinical signs and symptoms with brain function and in the creation of image based tools applicable to a broad range of clinical needs including diagnosis, monitoring and tracking of illness, predicting therapeutic response and development of new treatments. Papers dealing with structure and function in animal models will also be considered if they reveal mechanisms that can be readily translated to human conditions.
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