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Association Between Midlife Vascular Risk Factors and Estimated Brain Amyloid Deposition

JAMA : the journal of the American Medical Association, 2017-04, Vol.317 (14), p.1443 [Peer Reviewed Journal]

EISSN: 1538-3598 ;DOI: 10.1001/jama.2017.3090 ;PMID: 28399252

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Title:
Association Between Midlife Vascular Risk Factors and Estimated Brain Amyloid Deposition
Author: Gottesman, Rebecca F ; Schneider, Andrea L C ; Zhou, Yun ; Coresh, Josef ; Green, Edward ; Gupta, Naresh ; Knopman, David S ; Mintz, Akiva ; Rahmim, Arman ; Sharrett, A Richey ; Wagenknecht, Lynne E ; Wong, Dean F ; Mosley, Thomas H
Subjects: Age Factors ; Aged ; Aged, 80 and over ; Alleles ; Alzheimer Disease - genetics ; Amyloid - metabolism ; Aniline Compounds - pharmacokinetics ; Apolipoproteins E - genetics ; Blacks ; Body Mass Index ; Brain - diagnostic imaging ; Brain - metabolism ; Dementia - etiology ; Diabetes Complications ; Ethylene Glycols - pharmacokinetics ; Female ; Fluorine Radioisotopes - pharmacokinetics ; Follow-Up Studies ; Humans ; Hypercholesterolemia - complications ; Hypertension - complications ; Male ; Middle Aged ; Odds Ratio ; Positron-Emission Tomography - methods ; Prospective Studies ; Risk Factors ; Smoking - adverse effects ; Time Factors ; Whites
Is Part Of: JAMA : the journal of the American Medical Association, 2017-04, Vol.317 (14), p.1443
Description: Midlife vascular risk factors have been associated with late-life dementia. Whether these risk factors directly contribute to brain amyloid deposition is less well understood. To determine if midlife vascular risk factors are associated with late-life brain amyloid deposition, measured using florbetapir positron emission tomography (PET). The Atherosclerosis Risk in Communities (ARIC)-PET Amyloid Imaging Study, a prospective cohort study among 346 participants without dementia in 3 US communities (Washington County, Maryland; Forsyth County, North Carolina; and Jackson, Mississippi) who have been evaluated for vascular risk factors and markers since 1987-1989 with florbetapir PET scans in 2011-2013. Positron emission tomography image analysis was completed in 2015. Vascular risk factors at ARIC baseline (age 45-64 years; risk factors included body mass index ≥30, current smoking, hypertension, diabetes, and total cholesterol ≥200 mg/dL) were evaluated in multivariable models including age, sex, race, APOE genotype, and educational level. Standardized uptake value ratios (SUVRs) were calculated from PET scans and a mean global cortical SUVR was calculated. Elevated florbetapir (defined as a SUVR >1.2) was the dependent variable. Among 322 participants without dementia and with nonmissing midlife vascular risk factors at baseline (mean age, 52 years; 58% female; 43% black), the SUVR (elevated in 164 [50.9%] participants) was measured more than 20 years later (median follow-up, 23.5 years; interquartile range, 23.0-24.3 years) when participants were between 67 and 88 (mean, 76) years old. Elevated body mass index in midlife was associated with elevated SUVR (odds ratio [OR], 2.06; 95% CI, 1.16-3.65). At baseline, 65 participants had no vascular risk factors, 123 had 1, and 134 had 2 or more; a higher number of midlife risk factors was associated with elevated amyloid SUVR at follow-up (30.8% [n = 20], 50.4% [n = 62], and 61.2% [n = 82], respectively). In adjusted models, compared with 0 midlife vascular risk factors, the OR for elevated SUVR associated with 1 vascular risk factor was 1.88 (95% CI, 0.95-3.72) and for 2 or more vascular risk factors was 2.88 (95% CI, 1.46-5.69). No significant race × risk factor interactions were found. Late-life vascular risk factors were not associated with late-life brain amyloid deposition (for ≥2 late-life vascular risk factors vs 0: OR, 1.66; 95% CI, 0.75-3.69). An increasing number of midlife vascular risk factors was significantly associated with elevated amyloid SUVR; this association was not significant for late-life risk factors. These findings are consistent with a role of vascular disease in the development of Alzheimer disease.
Publisher: United States
Language: English
Identifier: EISSN: 1538-3598
DOI: 10.1001/jama.2017.3090
PMID: 28399252
Source: MEDLINE

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Association Between Midlife Vascular Risk Factors and Estimated Brain Amyloid Deposition

EISSN: 1538-3598 ;DOI: 10.1001/jama.2017.3090 ;PMID: 28399252

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