title: Cerebral Amyloid Angiopathy Is Associated With Executive Dysfunction and Mild Cognitive Impairment.
abstract: Autopsy studies suggest that cerebral amyloid angiopathy (CAA) is associated with cognitive impairment and risk for dementia. We analyzed neuropsychological test data from a prospective cohort study of patients with CAA to identify the prevalence of cognitive impairment and its associations with brain magnetic resonance imaging features and the apolipoprotein E genotype.
  
  
  
  Data were analyzed from 34 CAA, 16 Alzheimer's disease, 69 mild cognitive impairment, and 27 ischemic stroke participants. Neuropsychological test results were expressed as z scores in relation to normative data provided by the test manuals and then grouped into domains of memory, executive function, and processing speed.
  
  
  
  Mean test scores in CAA participants were significantly lower than norms for memory (-0.44±1.03; P=0.02), executive function (-1.14±1.07; P<0.001), and processing speed (-1.06±1.12; P<0.001). Twenty-seven CAA participants (79%) had mild cognitive impairment based on low cognitive performance accompanied by cognitive concerns. CAA participants had similarly low executive function scores as Alzheimer's disease, but relatively preserved memory. CAA participants' scores were lower than those of ischemic stroke controls for executive function and processing speed. Lower processing speed scores in CAA were associated with higher magnetic resonance imaging white matter hyperintensity volume. There were no associations with the apolipoprotein E ε4 allele.
  
  
  
  Mild cognitive impairment is very prevalent in CAA. The overall cognitive profile of CAA is more similar to that seen in vascular cognitive impairment rather than Alzheimer's disease. White matter ischemic lesions may underlie some of the impaired processing speed in CAA.
authors.affiliation: From the Department of Psychiatry, McGill University, Canada (N.F.C.); Department of Clinical Neurosciences, University of Calgary (A.C., A.Z., C.R.M., C.Z., R.F., B.G., A.H., E.E.S.), Department of Radiology (S.B., C.R.M., R.F., B.G.), Department of Medicine (D.B.H.), Hotchkiss Brain Institute (C.R.M., D.B.H., Z.I., S.B.C., R.F., B.G., E.E.S.), Department of Psychiatry (Z.I., S.B.C., E.E.S.), and Department of Community Health Sciences (S.B.C., E.E.S.), University of Calgary, Alberta, Canada; and Seaman Family MR Research Centre, Foothills Medical Centre, Alberta Health Services, Alberta, Canada (C.R.M., R.F., B.G.).
authors.forename: Nevicia F
authors.initials: NF
authors.lastname: Case
authors.affiliation: From the Department of Psychiatry, McGill University, Canada (N.F.C.); Department of Clinical Neurosciences, University of Calgary (A.C., A.Z., C.R.M., C.Z., R.F., B.G., A.H., E.E.S.), Department of Radiology (S.B., C.R.M., R.F., B.G.), Department of Medicine (D.B.H.), Hotchkiss Brain Institute (C.R.M., D.B.H., Z.I., S.B.C., R.F., B.G., E.E.S.), Department of Psychiatry (Z.I., S.B.C., E.E.S.), and Department of Community Health Sciences (S.B.C., E.E.S.), University of Calgary, Alberta, Canada; and Seaman Family MR Research Centre, Foothills Medical Centre, Alberta Health Services, Alberta, Canada (C.R.M., R.F., B.G.).
authors.forename: Anna
authors.initials: A
authors.lastname: Charlton
authors.affiliation: From the Department of Psychiatry, McGill University, Canada (N.F.C.); Department of Clinical Neurosciences, University of Calgary (A.C., A.Z., C.R.M., C.Z., R.F., B.G., A.H., E.E.S.), Department of Radiology (S.B., C.R.M., R.F., B.G.), Department of Medicine (D.B.H.), Hotchkiss Brain Institute (C.R.M., D.B.H., Z.I., S.B.C., R.F., B.G., E.E.S.), Department of Psychiatry (Z.I., S.B.C., E.E.S.), and Department of Community Health Sciences (S.B.C., E.E.S.), University of Calgary, Alberta, Canada; and Seaman Family MR Research Centre, Foothills Medical Centre, Alberta Health Services, Alberta, Canada (C.R.M., R.F., B.G.).
authors.forename: Angela
authors.initials: A
authors.lastname: Zwiers
authors.affiliation: From the Department of Psychiatry, McGill University, Canada (N.F.C.); Department of Clinical Neurosciences, University of Calgary (A.C., A.Z., C.R.M., C.Z., R.F., B.G., A.H., E.E.S.), Department of Radiology (S.B., C.R.M., R.F., B.G.), Department of Medicine (D.B.H.), Hotchkiss Brain Institute (C.R.M., D.B.H., Z.I., S.B.C., R.F., B.G., E.E.S.), Department of Psychiatry (Z.I., S.B.C., E.E.S.), and Department of Community Health Sciences (S.B.C., E.E.S.), University of Calgary, Alberta, Canada; and Seaman Family MR Research Centre, Foothills Medical Centre, Alberta Health Services, Alberta, Canada (C.R.M., R.F., B.G.).
authors.forename: Saima
authors.initials: S
authors.lastname: Batool
authors.affiliation: From the Department of Psychiatry, McGill University, Canada (N.F.C.); Department of Clinical Neurosciences, University of Calgary (A.C., A.Z., C.R.M., C.Z., R.F., B.G., A.H., E.E.S.), Department of Radiology (S.B., C.R.M., R.F., B.G.), Department of Medicine (D.B.H.), Hotchkiss Brain Institute (C.R.M., D.B.H., Z.I., S.B.C., R.F., B.G., E.E.S.), Department of Psychiatry (Z.I., S.B.C., E.E.S.), and Department of Community Health Sciences (S.B.C., E.E.S.), University of Calgary, Alberta, Canada; and Seaman Family MR Research Centre, Foothills Medical Centre, Alberta Health Services, Alberta, Canada (C.R.M., R.F., B.G.).
authors.forename: Cheryl R
authors.initials: CR
authors.lastname: McCreary
authors.affiliation: From the Department of Psychiatry, McGill University, Canada (N.F.C.); Department of Clinical Neurosciences, University of Calgary (A.C., A.Z., C.R.M., C.Z., R.F., B.G., A.H., E.E.S.), Department of Radiology (S.B., C.R.M., R.F., B.G.), Department of Medicine (D.B.H.), Hotchkiss Brain Institute (C.R.M., D.B.H., Z.I., S.B.C., R.F., B.G., E.E.S.), Department of Psychiatry (Z.I., S.B.C., E.E.S.), and Department of Community Health Sciences (S.B.C., E.E.S.), University of Calgary, Alberta, Canada; and Seaman Family MR Research Centre, Foothills Medical Centre, Alberta Health Services, Alberta, Canada (C.R.M., R.F., B.G.).
authors.forename: David B
authors.initials: DB
authors.lastname: Hogan
authors.affiliation: From the Department of Psychiatry, McGill University, Canada (N.F.C.); Department of Clinical Neurosciences, University of Calgary (A.C., A.Z., C.R.M., C.Z., R.F., B.G., A.H., E.E.S.), Department of Radiology (S.B., C.R.M., R.F., B.G.), Department of Medicine (D.B.H.), Hotchkiss Brain Institute (C.R.M., D.B.H., Z.I., S.B.C., R.F., B.G., E.E.S.), Department of Psychiatry (Z.I., S.B.C., E.E.S.), and Department of Community Health Sciences (S.B.C., E.E.S.), University of Calgary, Alberta, Canada; and Seaman Family MR Research Centre, Foothills Medical Centre, Alberta Health Services, Alberta, Canada (C.R.M., R.F., B.G.).
authors.forename: Zahinoor
authors.initials: Z
authors.lastname: Ismail
authors.affiliation: From the Department of Psychiatry, McGill University, Canada (N.F.C.); Department of Clinical Neurosciences, University of Calgary (A.C., A.Z., C.R.M., C.Z., R.F., B.G., A.H., E.E.S.), Department of Radiology (S.B., C.R.M., R.F., B.G.), Department of Medicine (D.B.H.), Hotchkiss Brain Institute (C.R.M., D.B.H., Z.I., S.B.C., R.F., B.G., E.E.S.), Department of Psychiatry (Z.I., S.B.C., E.E.S.), and Department of Community Health Sciences (S.B.C., E.E.S.), University of Calgary, Alberta, Canada; and Seaman Family MR Research Centre, Foothills Medical Centre, Alberta Health Services, Alberta, Canada (C.R.M., R.F., B.G.).
authors.forename: Charlotte
authors.initials: C
authors.lastname: Zerna
authors.affiliation: From the Department of Psychiatry, McGill University, Canada (N.F.C.); Department of Clinical Neurosciences, University of Calgary (A.C., A.Z., C.R.M., C.Z., R.F., B.G., A.H., E.E.S.), Department of Radiology (S.B., C.R.M., R.F., B.G.), Department of Medicine (D.B.H.), Hotchkiss Brain Institute (C.R.M., D.B.H., Z.I., S.B.C., R.F., B.G., E.E.S.), Department of Psychiatry (Z.I., S.B.C., E.E.S.), and Department of Community Health Sciences (S.B.C., E.E.S.), University of Calgary, Alberta, Canada; and Seaman Family MR Research Centre, Foothills Medical Centre, Alberta Health Services, Alberta, Canada (C.R.M., R.F., B.G.).
authors.forename: Shelagh B
authors.initials: SB
authors.lastname: Coutts
authors.affiliation: From the Department of Psychiatry, McGill University, Canada (N.F.C.); Department of Clinical Neurosciences, University of Calgary (A.C., A.Z., C.R.M., C.Z., R.F., B.G., A.H., E.E.S.), Department of Radiology (S.B., C.R.M., R.F., B.G.), Department of Medicine (D.B.H.), Hotchkiss Brain Institute (C.R.M., D.B.H., Z.I., S.B.C., R.F., B.G., E.E.S.), Department of Psychiatry (Z.I., S.B.C., E.E.S.), and Department of Community Health Sciences (S.B.C., E.E.S.), University of Calgary, Alberta, Canada; and Seaman Family MR Research Centre, Foothills Medical Centre, Alberta Health Services, Alberta, Canada (C.R.M., R.F., B.G.).
authors.forename: Richard
authors.initials: R
authors.lastname: Frayne
authors.affiliation: From the Department of Psychiatry, McGill University, Canada (N.F.C.); Department of Clinical Neurosciences, University of Calgary (A.C., A.Z., C.R.M., C.Z., R.F., B.G., A.H., E.E.S.), Department of Radiology (S.B., C.R.M., R.F., B.G.), Department of Medicine (D.B.H.), Hotchkiss Brain Institute (C.R.M., D.B.H., Z.I., S.B.C., R.F., B.G., E.E.S.), Department of Psychiatry (Z.I., S.B.C., E.E.S.), and Department of Community Health Sciences (S.B.C., E.E.S.), University of Calgary, Alberta, Canada; and Seaman Family MR Research Centre, Foothills Medical Centre, Alberta Health Services, Alberta, Canada (C.R.M., R.F., B.G.).
authors.forename: Brad
authors.initials: B
authors.lastname: Goodyear
authors.affiliation: From the Department of Psychiatry, McGill University, Canada (N.F.C.); Department of Clinical Neurosciences, University of Calgary (A.C., A.Z., C.R.M., C.Z., R.F., B.G., A.H., E.E.S.), Department of Radiology (S.B., C.R.M., R.F., B.G.), Department of Medicine (D.B.H.), Hotchkiss Brain Institute (C.R.M., D.B.H., Z.I., S.B.C., R.F., B.G., E.E.S.), Department of Psychiatry (Z.I., S.B.C., E.E.S.), and Department of Community Health Sciences (S.B.C., E.E.S.), University of Calgary, Alberta, Canada; and Seaman Family MR Research Centre, Foothills Medical Centre, Alberta Health Services, Alberta, Canada (C.R.M., R.F., B.G.).
authors.forename: Angela
authors.initials: A
authors.lastname: Haffenden
authors.affiliation: From the Department of Psychiatry, McGill University, Canada (N.F.C.); Department of Clinical Neurosciences, University of Calgary (A.C., A.Z., C.R.M., C.Z., R.F., B.G., A.H., E.E.S.), Department of Radiology (S.B., C.R.M., R.F., B.G.), Department of Medicine (D.B.H.), Hotchkiss Brain Institute (C.R.M., D.B.H., Z.I., S.B.C., R.F., B.G., E.E.S.), Department of Psychiatry (Z.I., S.B.C., E.E.S.), and Department of Community Health Sciences (S.B.C., E.E.S.), University of Calgary, Alberta, Canada; and Seaman Family MR Research Centre, Foothills Medical Centre, Alberta Health Services, Alberta, Canada (C.R.M., R.F., B.G.). eesmith@ucalgary.ca.
authors.forename: Eric E
authors.initials: EE
authors.lastname: Smith
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000483:Alleles; D001057:Apolipoproteins E / Q000235:genetics; D001921:Brain / Q000000981:diagnostic imaging*; D016657:Cerebral Amyloid Angiopathy / Q000150:complications* / Q000000981:diagnostic imaging / Q000235:genetics / Q000523:psychology; D003071:Cognition / Q000502:physiology*; D060825:Cognitive Dysfunction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000235:genetics / Q000523:psychology; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011446:Prospective Studies
chemical_list: D001057:Apolipoproteins E
keywords: Alzheimer’s disease; cerebral amyloid angiopathy; cognitive impairment; intracerebral hemorrhage; magnetic resonance imaging