Associations between amyloid-β load and cognition in cerebrovascular disease beyond cerebral amyloid angiopathy: a systematic review and meta-analysis of positron emission tomography studies.

IF 6 2区 医学 Q1 GERIATRICS & GERONTOLOGY Age and ageing Pub Date : 2024-10-01 DOI:10.1093/ageing/afae240
Jie Zhang, Cathy J Price, Ke Zhao, Yuanyuan Tang, Shuchang Zhong, Jingjing Lou, Xiangming Ye, Feng Liang
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Abstract

Background: There is growing interest in the comorbidity of vascular and neurodegenerative pathologies in patients with cerebrovascular disease (CVD) beyond cerebral amyloid angiopathy (CAA). However, the relationship between amyloid-β and vascular cognitive impairment (VCI) remains debated.

Objective: To investigate the association between VCI and amyloid-β deposition in non-CAA CVD patients.

Methods: PubMed, Embase, Web of Science, PsycINFO and CENTRAL databases were systematically searched. Observational studies, including case-control and cohort studies, associating cognitive scores with amyloid load measured by positron emission tomography were selected. Meta-analyses were performed to assess the strength of amyloid-cognition associations across CVD subtypes and cognitive domains. A random-effects model using the inverse variance method was used, with heterogeneity evaluated by Q-statistics and I2 statistics. Meta-regression analyses were conducted to examine the influence of moderators, and publication bias was assessed using funnel plots and Egger's test. All statistical analyses were performed using StataMP 18.

Results: Twenty-seven eligible studies encompassing 2894 participants were included. Among non-CAA CVD patients, global cognitive performance was significantly lower in those with higher amyloid-β deposition (standardized mean difference = -0.43, P < 0.001). The correlation strength varied across cognitive domains (executive function: r = -0.41; language: r = -0.36; memory: r = -0.29; all P < 0.001). The correlation was significant in patients with subcortical vascular disease (r = -0.43, P < 0.001) but not post-stroke patients (r = -0.19, P > 0.05).

Conclusions: Amyloid-β load is associated with cognitive decline in non-CAA CVD patients. This is more pronounced in patients with subcortical vascular disease than in post-stroke patients. Executive function is the most susceptible domain in VCI when the level of amyloid-β increases.

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脑淀粉样血管病以外的脑血管疾病中淀粉样蛋白-β负荷与认知能力之间的关系:正电子发射断层扫描研究的系统回顾和荟萃分析。
背景:除了脑淀粉样变性血管病(CAA)之外,人们对脑血管疾病(CVD)患者合并血管和神经退行性病变的问题越来越感兴趣。然而,淀粉样蛋白-β与血管性认知障碍(VCI)之间的关系仍存在争议:研究非 CAA 心血管疾病患者的 VCI 与淀粉样蛋白-β沉积之间的关系:方法:系统检索了 PubMed、Embase、Web of Science、PsycINFO 和 CENTRAL 数据库。筛选出将认知评分与正电子发射断层扫描测量的淀粉样蛋白负荷相关联的观察性研究,包括病例对照研究和队列研究。进行了元分析,以评估不同心血管疾病亚型和认知领域中淀粉样蛋白与认知相关性的强度。采用反方差法建立随机效应模型,通过Q统计量和I2统计量评估异质性。进行元回归分析以检查调节因子的影响,并使用漏斗图和 Egger 检验评估发表偏倚。所有统计分析均使用 StataMP 18 进行:共纳入了 27 项符合条件的研究,涉及 2894 名参与者。在非淀粉样蛋白-β沉积的心血管疾病患者中,淀粉样蛋白-β沉积较高者的整体认知能力明显较低(标准化平均差=-0.43,P<0.001)。不同认知领域的相关性强度各不相同(执行功能:r = -0.41;语言:r = -0.36;记忆:r = -0.29;所有 P <0.001)。皮层下血管疾病患者的相关性显著(r = -0.43,P <0.001),但卒中后患者的相关性不显著(r = -0.19,P >0.05):结论:淀粉样蛋白-β负荷与非CAA心血管疾病患者的认知能力下降有关。结论:淀粉样蛋白-β负荷与非脑血管疾病患者的认知能力下降有关,这在皮层下血管疾病患者中比脑卒中后患者中更为明显。当淀粉样蛋白-β水平升高时,执行功能是脑血管疾病患者最易受影响的领域。
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来源期刊
Age and ageing
Age and ageing 医学-老年医学
CiteScore
9.20
自引率
6.00%
发文量
796
审稿时长
4-8 weeks
期刊介绍: Age and Ageing is an international journal publishing refereed original articles and commissioned reviews on geriatric medicine and gerontology. Its range includes research on ageing and clinical, epidemiological, and psychological aspects of later life.
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