title: Stroke risk interacts with Alzheimer's disease biomarkers on brain aging outcomes.
abstract: Alzheimer's disease (AD) biomarkers and stroke risk factors independently predict cognitive impairment, likely through independent disease pathways. However, limited work has sought to describe the dynamic interplay between these important risk factors. This article evaluated the interaction between stroke risk and AD biomarkers on hippocampal volume and cognitive performance. We first evaluated the interaction between stroke risk factors and AD biomarkers using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI, n = 1202). We then extended our findings to an independent autopsy data set from the National Alzheimer's Coordinating Center (NACC, n = 1122) using measures of AD pathology. Stroke risk was quantified using the Framingham Stroke Risk Profile. In ADNI, stroke risk interacted with tau and amyloid levels in relation to baseline and longitudinal cognitive performance. Similarly, in NACC, stroke risk interacted with amyloid and tau positivity on cognitive performance. The effect of stroke risk factors on cognition was strongest in the absence of AD biomarkers or neuropathology, providing additional evidence that AD biomarkers and stroke risk factors relate to cognition through independent pathways.
authors.affiliation: Vanderbilt Memory and Alzheimer's Center, Vanderbilt University School of Medicine, Nashville, TN, USA. Electronic address: Timothy.J.Hohman@Vanderbilt.edu.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Hohman
authors.affiliation: Vanderbilt Memory and Alzheimer's Center, Vanderbilt University School of Medicine, Nashville, TN, USA; Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Lauren R
authors.initials: LR
authors.lastname: Samuels
authors.affiliation: Vanderbilt Memory and Alzheimer's Center, Vanderbilt University School of Medicine, Nashville, TN, USA; Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Dandan
authors.initials: D
authors.lastname: Liu
authors.affiliation: Vanderbilt Memory and Alzheimer's Center, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Gifford
authors.affiliation: Department of Medicine, University of Washington, Seattle, WA, USA.
authors.forename: Shubhabrata
authors.initials: S
authors.lastname: Mukherjee
authors.affiliation: Vanderbilt Memory and Alzheimer's Center, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Elleena M
authors.initials: EM
authors.lastname: Benson
authors.affiliation: Department of Pathology, Microbiology, and Immunology, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Ty
authors.initials: T
authors.lastname: Abel
authors.affiliation: Section of Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine and Boston Medical Center, Boston, MA, USA.
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Ruberg
authors.affiliation: Vanderbilt Memory and Alzheimer's Center, Vanderbilt University School of Medicine, Nashville, TN, USA.
authors.forename: Angela L
authors.initials: AL
authors.lastname: Jefferson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology*; D000544:Alzheimer Disease / Q000134:cerebrospinal fluid / Q000473:pathology*; D016229:Amyloid beta-Peptides / Q000134:cerebrospinal fluid; D015415:Biomarkers / Q000134:cerebrospinal fluid*; D001921:Brain / Q000378:metabolism / Q000473:pathology*; D003072:Cognition Disorders / Q000134:cerebrospinal fluid / Q000473:pathology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008569:Memory Disorders / Q000209:etiology; D008875:Middle Aged; D059906:Neuroimaging; D009483:Neuropsychological Tests; D010446:Peptide Fragments / Q000134:cerebrospinal fluid; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D020521:Stroke / Q000473:pathology*; D016875:tau Proteins / Q000134:cerebrospinal fluid
chemical_list: D016229:Amyloid beta-Peptides; D015415:Biomarkers; D010446:Peptide Fragments; C075222:amyloid beta-protein (1-42); D016875:tau Proteins
keywords: Aging; Alzheimer's disease; Biomarkers; Cerebrovascular disease; Cognition; Hippocampus; Stroke risk