Mid‐life and late‐life vascular risk factor burden and neuropathology in old age
Objective To determine whether vascular risk factor burden in mid‐ or late‐life associates with postmortem vascular and neurodegenerative pathologies in a community‐based sample. Methods We studied participants from the Framingham Heart Study who participated in our voluntary brain bank program. Ove...
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| Veröffentlicht in: | Annals of clinical and translational neurology Jg. 6; H. 12; S. 2403 - 2412 |
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| Hauptverfasser: | , , , , , , , , , , , |
| Format: | Journal Article |
| Sprache: | Englisch |
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United States
John Wiley & Sons, Inc
01.12.2019
John Wiley and Sons Inc Wiley |
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| ISSN: | 2328-9503, 2328-9503 |
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| Abstract | Objective
To determine whether vascular risk factor burden in mid‐ or late‐life associates with postmortem vascular and neurodegenerative pathologies in a community‐based sample.
Methods
We studied participants from the Framingham Heart Study who participated in our voluntary brain bank program. Overall vascular risk factor burden was calculated using the Framingham Stroke Risk Profile (FSRP). Mid‐life FSRP was measured at 50 to 60 years of age. Following death, brains were autopsied and semi‐quantitatively assessed by board‐certified neuropathologists for cerebrovascular outcomes (cortical infarcts, subcortical infarcts, atherosclerosis, arteriosclerosis) and Alzheimer’s disease pathology (Braak stage, cerebral amyloid angiopathy, and neuritic plaque score). We estimated adjusted odds ratios between vascular risk burden (at mid‐life and before death) and neuropathological outcomes using logistic and proportional‐odds logistic models.
Results
The median time interval between FSRP and death was 33.4 years for mid‐life FSRP and 4.4 years for final FSRP measurement before death. Higher mid‐life vascular risk burden was associated with increased odds of all cerebrovascular pathology, even with adjustment for vascular risk burden before death. Late‐life vascular risk burden was associated with increased odds of cortical infarcts (OR [95% CI]: 1.04 [1.00, 1.08]) and arteriosclerosis stage (OR [95% CI]: 1.03 [1.00, 1.05]). Mid‐life vascular risk burden was not associated with Alzheimer’s disease pathology, though late‐life vascular risk burden was associated with increased odds of higher Braak stage (OR [95% CI]: 1.03 [1.01, 1.05]).
Interpretation
Mid‐life vascular risk burden was predictive of cerebrovascular but not Alzheimer’s disease neuropathology, even after adjustment for vascular risk factors before death. |
|---|---|
| AbstractList | ObjectiveTo determine whether vascular risk factor burden in mid‐ or late‐life associates with postmortem vascular and neurodegenerative pathologies in a community‐based sample.MethodsWe studied participants from the Framingham Heart Study who participated in our voluntary brain bank program. Overall vascular risk factor burden was calculated using the Framingham Stroke Risk Profile (FSRP). Mid‐life FSRP was measured at 50 to 60 years of age. Following death, brains were autopsied and semi‐quantitatively assessed by board‐certified neuropathologists for cerebrovascular outcomes (cortical infarcts, subcortical infarcts, atherosclerosis, arteriosclerosis) and Alzheimer’s disease pathology (Braak stage, cerebral amyloid angiopathy, and neuritic plaque score). We estimated adjusted odds ratios between vascular risk burden (at mid‐life and before death) and neuropathological outcomes using logistic and proportional‐odds logistic models.ResultsThe median time interval between FSRP and death was 33.4 years for mid‐life FSRP and 4.4 years for final FSRP measurement before death. Higher mid‐life vascular risk burden was associated with increased odds of all cerebrovascular pathology, even with adjustment for vascular risk burden before death. Late‐life vascular risk burden was associated with increased odds of cortical infarcts (OR [95% CI]: 1.04 [1.00, 1.08]) and arteriosclerosis stage (OR [95% CI]: 1.03 [1.00, 1.05]). Mid‐life vascular risk burden was not associated with Alzheimer’s disease pathology, though late‐life vascular risk burden was associated with increased odds of higher Braak stage (OR [95% CI]: 1.03 [1.01, 1.05]).InterpretationMid‐life vascular risk burden was predictive of cerebrovascular but not Alzheimer’s disease neuropathology, even after adjustment for vascular risk factors before death. To determine whether vascular risk factor burden in mid- or late-life associates with postmortem vascular and neurodegenerative pathologies in a community-based sample.OBJECTIVETo determine whether vascular risk factor burden in mid- or late-life associates with postmortem vascular and neurodegenerative pathologies in a community-based sample.We studied participants from the Framingham Heart Study who participated in our voluntary brain bank program. Overall vascular risk factor burden was calculated using the Framingham Stroke Risk Profile (FSRP). Mid-life FSRP was measured at 50 to 60 years of age. Following death, brains were autopsied and semi-quantitatively assessed by board-certified neuropathologists for cerebrovascular outcomes (cortical infarcts, subcortical infarcts, atherosclerosis, arteriosclerosis) and Alzheimer's disease pathology (Braak stage, cerebral amyloid angiopathy, and neuritic plaque score). We estimated adjusted odds ratios between vascular risk burden (at mid-life and before death) and neuropathological outcomes using logistic and proportional-odds logistic models.METHODSWe studied participants from the Framingham Heart Study who participated in our voluntary brain bank program. Overall vascular risk factor burden was calculated using the Framingham Stroke Risk Profile (FSRP). Mid-life FSRP was measured at 50 to 60 years of age. Following death, brains were autopsied and semi-quantitatively assessed by board-certified neuropathologists for cerebrovascular outcomes (cortical infarcts, subcortical infarcts, atherosclerosis, arteriosclerosis) and Alzheimer's disease pathology (Braak stage, cerebral amyloid angiopathy, and neuritic plaque score). We estimated adjusted odds ratios between vascular risk burden (at mid-life and before death) and neuropathological outcomes using logistic and proportional-odds logistic models.The median time interval between FSRP and death was 33.4 years for mid-life FSRP and 4.4 years for final FSRP measurement before death. Higher mid-life vascular risk burden was associated with increased odds of all cerebrovascular pathology, even with adjustment for vascular risk burden before death. Late-life vascular risk burden was associated with increased odds of cortical infarcts (OR [95% CI]: 1.04 [1.00, 1.08]) and arteriosclerosis stage (OR [95% CI]: 1.03 [1.00, 1.05]). Mid-life vascular risk burden was not associated with Alzheimer's disease pathology, though late-life vascular risk burden was associated with increased odds of higher Braak stage (OR [95% CI]: 1.03 [1.01, 1.05]).RESULTSThe median time interval between FSRP and death was 33.4 years for mid-life FSRP and 4.4 years for final FSRP measurement before death. Higher mid-life vascular risk burden was associated with increased odds of all cerebrovascular pathology, even with adjustment for vascular risk burden before death. Late-life vascular risk burden was associated with increased odds of cortical infarcts (OR [95% CI]: 1.04 [1.00, 1.08]) and arteriosclerosis stage (OR [95% CI]: 1.03 [1.00, 1.05]). Mid-life vascular risk burden was not associated with Alzheimer's disease pathology, though late-life vascular risk burden was associated with increased odds of higher Braak stage (OR [95% CI]: 1.03 [1.01, 1.05]).Mid-life vascular risk burden was predictive of cerebrovascular but not Alzheimer's disease neuropathology, even after adjustment for vascular risk factors before death.INTERPRETATIONMid-life vascular risk burden was predictive of cerebrovascular but not Alzheimer's disease neuropathology, even after adjustment for vascular risk factors before death. Objective To determine whether vascular risk factor burden in mid‐ or late‐life associates with postmortem vascular and neurodegenerative pathologies in a community‐based sample. Methods We studied participants from the Framingham Heart Study who participated in our voluntary brain bank program. Overall vascular risk factor burden was calculated using the Framingham Stroke Risk Profile (FSRP). Mid‐life FSRP was measured at 50 to 60 years of age. Following death, brains were autopsied and semi‐quantitatively assessed by board‐certified neuropathologists for cerebrovascular outcomes (cortical infarcts, subcortical infarcts, atherosclerosis, arteriosclerosis) and Alzheimer’s disease pathology (Braak stage, cerebral amyloid angiopathy, and neuritic plaque score). We estimated adjusted odds ratios between vascular risk burden (at mid‐life and before death) and neuropathological outcomes using logistic and proportional‐odds logistic models. Results The median time interval between FSRP and death was 33.4 years for mid‐life FSRP and 4.4 years for final FSRP measurement before death. Higher mid‐life vascular risk burden was associated with increased odds of all cerebrovascular pathology, even with adjustment for vascular risk burden before death. Late‐life vascular risk burden was associated with increased odds of cortical infarcts (OR [95% CI]: 1.04 [1.00, 1.08]) and arteriosclerosis stage (OR [95% CI]: 1.03 [1.00, 1.05]). Mid‐life vascular risk burden was not associated with Alzheimer’s disease pathology, though late‐life vascular risk burden was associated with increased odds of higher Braak stage (OR [95% CI]: 1.03 [1.01, 1.05]). Interpretation Mid‐life vascular risk burden was predictive of cerebrovascular but not Alzheimer’s disease neuropathology, even after adjustment for vascular risk factors before death. To determine whether vascular risk factor burden in mid- or late-life associates with postmortem vascular and neurodegenerative pathologies in a community-based sample. We studied participants from the Framingham Heart Study who participated in our voluntary brain bank program. Overall vascular risk factor burden was calculated using the Framingham Stroke Risk Profile (FSRP). Mid-life FSRP was measured at 50 to 60 years of age. Following death, brains were autopsied and semi-quantitatively assessed by board-certified neuropathologists for cerebrovascular outcomes (cortical infarcts, subcortical infarcts, atherosclerosis, arteriosclerosis) and Alzheimer's disease pathology (Braak stage, cerebral amyloid angiopathy, and neuritic plaque score). We estimated adjusted odds ratios between vascular risk burden (at mid-life and before death) and neuropathological outcomes using logistic and proportional-odds logistic models. The median time interval between FSRP and death was 33.4 years for mid-life FSRP and 4.4 years for final FSRP measurement before death. Higher mid-life vascular risk burden was associated with increased odds of all cerebrovascular pathology, even with adjustment for vascular risk burden before death. Late-life vascular risk burden was associated with increased odds of cortical infarcts (OR [95% CI]: 1.04 [1.00, 1.08]) and arteriosclerosis stage (OR [95% CI]: 1.03 [1.00, 1.05]). Mid-life vascular risk burden was not associated with Alzheimer's disease pathology, though late-life vascular risk burden was associated with increased odds of higher Braak stage (OR [95% CI]: 1.03 [1.01, 1.05]). Mid-life vascular risk burden was predictive of cerebrovascular but not Alzheimer's disease neuropathology, even after adjustment for vascular risk factors before death. Abstract Objective To determine whether vascular risk factor burden in mid‐ or late‐life associates with postmortem vascular and neurodegenerative pathologies in a community‐based sample. Methods We studied participants from the Framingham Heart Study who participated in our voluntary brain bank program. Overall vascular risk factor burden was calculated using the Framingham Stroke Risk Profile (FSRP). Mid‐life FSRP was measured at 50 to 60 years of age. Following death, brains were autopsied and semi‐quantitatively assessed by board‐certified neuropathologists for cerebrovascular outcomes (cortical infarcts, subcortical infarcts, atherosclerosis, arteriosclerosis) and Alzheimer’s disease pathology (Braak stage, cerebral amyloid angiopathy, and neuritic plaque score). We estimated adjusted odds ratios between vascular risk burden (at mid‐life and before death) and neuropathological outcomes using logistic and proportional‐odds logistic models. Results The median time interval between FSRP and death was 33.4 years for mid‐life FSRP and 4.4 years for final FSRP measurement before death. Higher mid‐life vascular risk burden was associated with increased odds of all cerebrovascular pathology, even with adjustment for vascular risk burden before death. Late‐life vascular risk burden was associated with increased odds of cortical infarcts (OR [95% CI]: 1.04 [1.00, 1.08]) and arteriosclerosis stage (OR [95% CI]: 1.03 [1.00, 1.05]). Mid‐life vascular risk burden was not associated with Alzheimer’s disease pathology, though late‐life vascular risk burden was associated with increased odds of higher Braak stage (OR [95% CI]: 1.03 [1.01, 1.05]). Interpretation Mid‐life vascular risk burden was predictive of cerebrovascular but not Alzheimer’s disease neuropathology, even after adjustment for vascular risk factors before death. |
| Author | Stein, Thor D. Himali, Jayandra J. Raman, Mekala R. Carneiro, Herman Walker, Jamie M. Pase, Matthew P. Beiser, Alexa Seshadri, Sudha Conner, Sarah C. McKee, Ann C. Alvarez, Victor E. Satizabal, Claudia L. |
| AuthorAffiliation | 2 Department of Biostatistics Boston University School of Public Health Boston Massachusetts 8 Boston University Alzheimer's Disease and CTE Center Boston University School of Medicine Boston Massachusetts 9 Department of Veterans Affairs Medical Center Bedford Massachusetts 1 Framingham Heart Study Framingham Massachusetts 6 Department of Medicine Boston University School of Medicine Boston Massachusetts 10 VA Boston Healthcare System Boston Massachusetts 11 Department of Pathology and Laboratory Medicine Boston University School of Medicine Boston Massachusetts 12 Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases UT Health San Antonio San Antonio Texas 4 Centre for Human Psychopharmacology Swinburne University of Technology Melbourne Australia 3 Melbourne Dementia Research Centre The Florey Institute for Neuroscience and Mental Health Melbourne Australia 5 Faculty of Medicine Dentistry and Health Sciences The University of Melbourne Melbourne Australia 7 Department of Neurolo |
| AuthorAffiliation_xml | – name: 6 Department of Medicine Boston University School of Medicine Boston Massachusetts – name: 4 Centre for Human Psychopharmacology Swinburne University of Technology Melbourne Australia – name: 9 Department of Veterans Affairs Medical Center Bedford Massachusetts – name: 11 Department of Pathology and Laboratory Medicine Boston University School of Medicine Boston Massachusetts – name: 3 Melbourne Dementia Research Centre The Florey Institute for Neuroscience and Mental Health Melbourne Australia – name: 5 Faculty of Medicine Dentistry and Health Sciences The University of Melbourne Melbourne Australia – name: 8 Boston University Alzheimer's Disease and CTE Center Boston University School of Medicine Boston Massachusetts – name: 1 Framingham Heart Study Framingham Massachusetts – name: 2 Department of Biostatistics Boston University School of Public Health Boston Massachusetts – name: 7 Department of Neurology Boston University School of Medicine Boston Massachusetts – name: 10 VA Boston Healthcare System Boston Massachusetts – name: 12 Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases UT Health San Antonio San Antonio Texas |
| Author_xml | – sequence: 1 givenname: Sarah C. orcidid: 0000-0002-0929-9948 surname: Conner fullname: Conner, Sarah C. organization: Boston University School of Public Health – sequence: 2 givenname: Matthew P. surname: Pase fullname: Pase, Matthew P. organization: The University of Melbourne – sequence: 3 givenname: Herman surname: Carneiro fullname: Carneiro, Herman organization: Boston University School of Medicine – sequence: 4 givenname: Mekala R. surname: Raman fullname: Raman, Mekala R. organization: Boston University School of Medicine – sequence: 5 givenname: Ann C. surname: McKee fullname: McKee, Ann C. organization: Boston University School of Medicine – sequence: 6 givenname: Victor E. surname: Alvarez fullname: Alvarez, Victor E. organization: Boston University School of Medicine – sequence: 7 givenname: Jamie M. surname: Walker fullname: Walker, Jamie M. organization: UT Health San Antonio – sequence: 8 givenname: Claudia L. surname: Satizabal fullname: Satizabal, Claudia L. organization: UT Health San Antonio – sequence: 9 givenname: Jayandra J. surname: Himali fullname: Himali, Jayandra J. organization: UT Health San Antonio – sequence: 10 givenname: Thor D. surname: Stein fullname: Stein, Thor D. organization: Boston University School of Medicine – sequence: 11 givenname: Alexa surname: Beiser fullname: Beiser, Alexa organization: Boston University School of Medicine – sequence: 12 givenname: Sudha surname: Seshadri fullname: Seshadri, Sudha email: suseshad@bu.edu organization: UT Health San Antonio |
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| Copyright | 2019 The Authors. published by Wiley Periodicals, Inc on behalf of American Neurological Association. 2019 The Authors. Annals of Clinical and Translational Neurology published by Wiley Periodicals, Inc on behalf of American Neurological Association. 2019. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. |
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| DOI | 10.1002/acn3.50936 |
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| Notes | Funding information Ms. Conner reports funding from the National Institute of General Medical Sciences (NIGMS) Interdisciplinary Training Grant for Biostatisticians (T32GM74905‐14) and the National Heart, Lung, and Blood Institute (NHLBI) (F31HL145904‐01). Dr. Raman reports funding from NHLBI (T32HL125232‐01A1). Dr. Satizabal is supported by the Alzheimer’s Association (AARGD‐16‐443384). Dr. Pase is funded by a National Heart Foundation of Australia Future Leader Fellowship (ID, 102052). This study was also supported by grants from the National Institute on Aging (R01 AG054076, R01 AG049607, R01 AG033193, U01 AG049505, U01 AG052409, RF1 AG054156) and the National Institute of Neurological Disorders and Stroke (NS017950 and UH2 NS100605), and the NHLBI contract for the Framingham Heart Study (contract no. N01‐HC‐25195, HHSN268201500001I, and 75N92019D00031). ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 |
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To determine whether vascular risk factor burden in mid‐ or late‐life associates with postmortem vascular and neurodegenerative pathologies in a... To determine whether vascular risk factor burden in mid- or late-life associates with postmortem vascular and neurodegenerative pathologies in a... ObjectiveTo determine whether vascular risk factor burden in mid‐ or late‐life associates with postmortem vascular and neurodegenerative pathologies in a... Abstract Objective To determine whether vascular risk factor burden in mid‐ or late‐life associates with postmortem vascular and neurodegenerative pathologies... |
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| SubjectTerms | Age Aged Aged, 80 and over Alzheimer Disease - epidemiology Alzheimer Disease - pathology Alzheimer's disease Arteriosclerosis Atherosclerosis Blood pressure Brain Cardiac arrhythmia Cardiovascular disease Cerebrovascular Disorders - epidemiology Cerebrovascular Disorders - pathology Dementia Diabetes Donations Female Gender Humans Hypertension Longitudinal Studies Male Massachusetts - epidemiology Middle Aged Neuropathology Pathology Prognosis Risk Factors Standard deviation Tissue Banks |
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| Title | Mid‐life and late‐life vascular risk factor burden and neuropathology in old age |
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