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Abstract
Objective: To determine arterial stiffness and β-amyloid (Aβ) deposition in the brain of dementia-free older adults.
Methods: We studied a cohort of 91 dementia-free participants aged 83–96 years. In 2009, participants completed brain MRI and PET imaging using Pittsburgh compound B (PiB; a marker of amyloid plaques in human brain). In 2011, we measured resting blood pressure (BP), mean arterial pressure (MAP), and arterial stiffness by pulse wave velocity (PWV) in the central, peripheral, and mixed (e.g., brachial ankle PWV [baPWV]) vascular beds, using a noninvasive and automated waveform analyzer.
Results: A total of 44/91 subjects were Aβ-positive on PET scan. Aβ deposition was associated with mixed PWV, systolic BP, and MAP. One SD increase in baPWV resulted in a 2-fold increase in the odds of being Aβ-positive (p = 0.007). High white matter hyperintensity (WMH) burden was associated with increased central PWV, systolic BP, and MAP. Compared to Aβ-negative individuals with low WMH burden, each SD increase in PWV was associated with a 2-fold to 4-fold increase in the odds of being Aβ-positive and having high WMH.
Conclusions: Arterial stiffness was associated with Aβ plaque deposition in the brain, independent of BP and APOE ε4 allele. The associations differed by type of brain abnormality and vascular bed measured (e.g., WMH with central stiffness and Aβ deposition and mixed stiffness). Arterial stiffness was highest in individuals with both high Aβ deposition and WMH, which has been suggested to be a “double hit” contributing to the development of symptomatic dementia.
GLOSSARY
- Aβ=
- β-amyloid;
- AD=
- Alzheimer disease;
- baPWV=
- brachial-ankle pulse wave velocity;
- BMI=
- body mass index;
- BP=
- blood pressure;
- cfPWV=
- carotid-femoral pulse wave velocity;
- CI=
- confidence interval;
- DBP=
- diastolic blood pressure;
- faPWV=
- femoral-ankle pulse wave velocity;
- GEMS=
- Ginkgo Evaluation of Memory Study;
- hfPWV=
- heart-femoral pulse wave velocity;
- ICC=
- intraclass correlation coefficients;
- MAP=
- mean arterial pressure;
- MCI=
- mild cognitive impairment;
- OR=
- odds ratio;
- PiB=
- Pittsburgh compound B;
- PWV=
- pulse wave velocity;
- SBP=
- systolic blood pressure;
- WMH=
- white matter hyperintensities;
- WMHv=
- white matter hyperintensities volume
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at www.neurology.org
- Received April 23, 2013.
- Accepted in final form August 12, 2013.
- © 2013 American Academy of Neurology
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