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O2–09–02: Cerebrovascular and Alzheimer's disease: A synergistic pathogenesis
Author(s) -
Goos Jeroen,
Kester Maartje,
Teunissen Charlotte,
Bouwman Femke,
Barkhof Frederik,
Scheltens Philip,
Van der Flier Wiesje
Publication year - 2013
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2013.04.184
Subject(s) - medicine , dementia , hyperintensity , memory clinic , cardiology , atrophy , amyloid (mycology) , vascular dementia , cohort , pathology , alzheimer's disease , white matter , magnetic resonance imaging , disease , radiology
internationally accepted criteria, and AD cases were further classified for the presence of cerebrovascular disease (CBVD). Controls with no history of stroke and cognitive impairment were selected from the Singapore Epidemiology of Eye Disease program and matched by race, gender and 5year age groups. Retinal vascular parameters (retinal vascular caliber, fractal dimension and tortuosity) were assessed using a semi-automated computer-based program. Due to its skewed distribution, retinal vessel tortuosity was log-transformed. Logistic regression models were constructed adjusting for gender, age, hypertension, diabetes and hypercholesterolemia status. Results: A total of 156 AD cases (98 without CBVD and 58with CBVD), 27 vascular dementia cases, and 493 controls were included in this preliminary analysis. Narrower arteriolar caliber was associated with VaD (multivariable-adjusted odds ratio (OR) per standard deviation (SD) decrease: 2.41; 95%CI: 1.13-5.14) and AD with CBVD (OR per SD decrease: 1.84; 95%CI: 1.05-3.23). Narrower venular caliber (OR per SD decrease: 1.72; 95%CI: 1.11-2.68), decreased arteriolar fractal dimension (OR per SD decrease: 1.29; 95%CI: 1.03-1.61) and venular fractal dimension (OR per SD increase: 1.36; 95%CI: 1.08-1.72) were associated with only AD without CBVD. However, increased arteriolar and venular tortuosity was associated with all three subtypes of dementia. Conclusions: A sparser retinal microvascular network was associated with AD, whereas narrower arterioles were associated with dementia linked to CBVD, and tortuous retinal vessels were associated with all three subtypes of dementia. This suggests that retinal vascular parameters may potentially useful in assessing the contribution of microvascular pathology to the different subtpyes of dementia.