title: Cerebral amyloid angiopathy and its co-occurrence with Alzheimer's disease and other cerebrovascular neuropathologic changes.
abstract: We examined the relationship between cerebral amyloid angiopathy (CAA), Alzheimer's disease neuropathologic changes, other vascular brain pathologies, and cognition in a large multicenter autopsy sample. Data were obtained from the National Alzheimer's Coordinating Center on autopsied subjects (N = 3976) who died between 2002 and 2012. Descriptive statistics and multivariable regression models estimated the associations between CAA and other pathologies, and between CAA severity and cognitive test scores proximal to death. CAA tended to co-occur with Alzheimer's disease neuropathologic changes but a minority of cases were discrepant. CAA was absent in 22% (n = 520) of subjects with frequent neuritic plaques but present in 20.9% (n = 91) of subjects with no neuritic plaques. In subjects with no/sparse neuritic plaques, nonhemorrhagic brain infarcts were more common in those with CAA pathology than without (p = 0.007). In subjects without the APOE ε4 allele, CAA severity was associated with lower cognition proximal to death, factoring in other pathologies. The presence of CAA in patients without Alzheimer's disease may indicate a distinct cerebrovascular condition.
authors.affiliation: National Alzheimer's Coordinating Center, Department of Epidemiology, University of Washington, Seattle, WA, USA. Electronic address: wbrenow@u.washington.edu.
authors.forename: Willa D
authors.initials: WD
authors.lastname: Brenowitz
authors.affiliation: Department of Pathology, Division of Neuropathology, University of Kentucky, Lexington, KY, USA; Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA.
authors.forename: Peter T
authors.initials: PT
authors.lastname: Nelson
authors.affiliation: National Alzheimer's Coordinating Center, Department of Epidemiology, University of Washington, Seattle, WA, USA.
authors.forename: Lilah M
authors.initials: LM
authors.lastname: Besser
authors.affiliation: International Clinical Research Center, Department of Global Health, University of Washington, Seattle, WA, USA.
authors.forename: Katherine B
authors.initials: KB
authors.lastname: Heller
authors.affiliation: National Alzheimer's Coordinating Center, Department of Epidemiology, University of Washington, Seattle, WA, USA.
authors.forename: Walter A
authors.initials: WA
authors.lastname: Kukull
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000483:Alleles; D000544:Alzheimer Disease / Q000150:complications* / Q000473:pathology / Q000523:psychology; D001057:Apolipoproteins E / Q000235:genetics; D001921:Brain / Q000473:pathology*; D016657:Cerebral Amyloid Angiopathy / Q000150:complications* / Q000473:pathology / Q000523:psychology; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000473:pathology / Q000523:psychology; D003071:Cognition; D005260:Female; D006801:Humans; D008297:Male; D015337:Multicenter Studies as Topic; D012044:Regression Analysis; D012720:Severity of Illness Index
chemical_list: D001057:Apolipoproteins E
keywords: Alzheimer's disease neuropathologic change; Cerebral amyloid angiopathy; Cerebrovascular disease; Cognition; Neuropathology