Abstract Details

Title Association of Autopsy Markers of Brain Vascular Disease and of Alzheimer's Disease with Cortical Atrophy: Results from the Rush Memory and Aging Project

Topic Aging and Dementia

Presentation(s) P04 - (-)

Poster/Presentation
Number 221

Objective

Background BACKGROUND: Cortical atrophy and brain vascular disease are both associated with dementia, particularly in the oldest-old, but only one previous pathological study has examined the association of brain vascular disease with cortical atrophy.

Design/Methods DESIGN/METHODS: We studied pathological material from the Rush Memory and Aging Project (N = 363). Cortical and hippocampal atrophy, and brain vascular atherosclerosis (large vessel disease [LVD] and lipohyalinosis (small vessel disease [SVD]) were rated by 2 neuropathologists who were unaware of this study's hypothesis. Quantitative measures of Alzheimer's disease (AD), neuritic and amyloid burden, were also obtained. Micro and macroscopic infarcts were noted. The relationship between predictors and atrophy was assessed with linear regression models.

Results RESULTS: In models that included LVD and SVD, amyloid load and neuritic load, age at death, and micro and macroscopic infarcts, LVD was the only marker significantly associated with cortical atrophy (standardized ? = 0.16, CI: 0.05-0.33, p = .009). In contrast, neuritic pathology (? = 0.19, CI: 0.07 to 0.49, p = 0.008) was the only significant predictor of hippocampal atrophy.

Conclusions CONCLUSIONS: Cortical atrophy was significantly associated with LVD, but not with amyloid or neuritic pathology. Hippocampal atrophy was associated with neuritic, but not vascular, pathology. These findings suggest that a process other than Alzheimer's disease may be leading to cortical atrophy. As cortical atrophy is strongly associated with cognitive impairment, future studies should test the hypothesis that diagnosis and treatment of large vessel disease may be associated with less cognitive impairment in the elderly.

Authors/Disclosures
Howard A. Crystal, MD, FAAN PRESENTER	An immediate family member of Dr. Crystal has received personal compensation for serving as an employee of C4 TherAPEUTICS. An immediate family member of Dr. Crystal has stock in c4 THERAPEUTICS. Dr. Crystal has stock in c4 THERAPEUTICS.
Julie A. Schneider, MD, MS (Rush Alzheimer'S Disease Center)	Dr. Schneider has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Eli Lilly. Dr. Schneider has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for alnylam. Dr. Schneider has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for apellis. Dr. Schneider has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for National Hockey League. The institution of Dr. Schneider has received research support from NIH. Dr. Schneider has received personal compensation in the range of $500-$4,999 for serving as a scientific advisor with Fondation Alzheimer, France.
Diana Rojas-Soto, MD (Dartmouth- Hitchcock Medical Center)	Dr. Rojas-Soto has nothing to disclose.
	No disclosure on file
James M. Meyer, PharmD (Marathon Pharmaceuticals, LLC)	No disclosure on file
David A. Bennett, MD (Rush University Medical Center)	Dr. Bennett has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Annovis. Dr. Bennett has received personal compensation in the range of $500-$4,999 for serving as a Consultant for New Amsterdam. Dr. Bennett has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AbbVie. Dr. Bennett has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for AbbVie.
Steven Levine, MD, FAHA (SUNY Downstate Medical Center)	Dr. Levine has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for MEDLINK. Dr. Levine has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for Law Firms. The institution of Dr. Levine has received research support from NIH.

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