Isabelle Pelcher1, Christian Puzo1, Yorghos Tripodis2, Hugo J Aparicio1,3,4,5, Eric G Steinberg1, Alyssa Phelps1, Brett Martin6, Joseph N Palmisano6, Elizabeth Vassey1, Cutter Lindbergh7, Ann C McKee1,3,4,8,9, Thor D Stein1,4,5,8,9, Ronald J Killiany1,10, Rhoda Au1,3,5,10,11, Neil W Kowall1,3,4, Robert A Stern1,3,10,12, Jesse Mez1,3, Michael L Alosco1,3. 1. Boston University Alzheimer's Disease Center and CTE Center, Boston University School of Medicine, Boston, MA, USA. 2. Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA. 3. Department of Neurology, Boston University School of Medicine, Boston, MA, USA. 4. VA Boston Healthcare System, U.S. Department of Veteran Affairs, Boston, MA, USA. 5. Framingham Heart Study, National Heart, Lung, and Blood, Framingham, MA, USA. 6. Biostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA, USA. 7. Department of Neurology, University of California, San Francisco, San Francisco, CA, USA. 8. Department of Pathology and Laboratory Medicine, Boston University School of Medicine, Boston, MA, USA. 9. Department of Veterans Affairs Medical Center, Bedford, MA, USA. 10. Department of Anatomy & Neurobiology, Boston University School of Medicine, Boston, MA, USA. 11. Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA. 12. Department of Neurosurgery, Boston University School of Medicine, Boston, MA, USA.
Abstract
BACKGROUND: The Framingham Stroke Risk Profile (FSRP) was created in 1991 to estimate 10-year risk of stroke. It was revised in 2017 (rFSRP) to reflect the modern data on vascular risk factors and stroke risk. OBJECTIVE: This study examined the association between the rFSRP and cognitive and brain aging outcomes among participants from the National Alzheimer's Coordinating Center (NACC) Uniform Data Set (UDS). METHODS: Cross-sectional rFSRP was computed at baseline for 19,309 participants (mean age = 72.84, SD = 8.48) from the NACC-UDS [9,697 (50.2%) normal cognition, 4,705 (24.4%) MCI, 4,907 (25.4%) dementia]. Multivariable linear, logistic, or ordinal regressions examined the association between the rFSRP and diagnostic status, neuropsychological test performance, CDR® Sum of Boxes, as well as total brain volume (TBV), hippocampal volume (HCV), and log-transformed white matter hyperintensities (WMH) for an MRI subset (n = 1,196). Models controlled for age, sex, education, racial identity, APOEɛ4 status, and estimated intracranial volume for MRI models. RESULTS: The mean rFSRP probability was 10.42% (min = 0.50%, max = 95.71%). Higher rFSRP scores corresponded to greater CDR Sum of Boxes (β= 0.02, p = 0.028) and worse performance on: Trail Making Test A (β= 0.05, p < 0.001) and B (β= 0.057, p < 0.001), and Digit Symbol (β= -0.058, p < 0.001). Higher rFSRP scores were associated with increased odds for a greater volume of log-transformed WMH (OR = 1.02 per quartile, p = 0.015). No associations were observed for diagnosis, episodic memory or language test scores, HCV, or TBV. CONCLUSION: These results support the rFSRP as a useful metric to facilitate clinical research on the associations between cerebrovascular disease and cognitive and brain aging.
BACKGROUND: The Framingham Stroke Risk Profile (FSRP) was created in 1991 to estimate 10-year risk of stroke. It was revised in 2017 (rFSRP) to reflect the modern data on vascular risk factors and stroke risk. OBJECTIVE: This study examined the association between the rFSRP and cognitive and brain aging outcomes among participants from the National Alzheimer's Coordinating Center (NACC) Uniform Data Set (UDS). METHODS: Cross-sectional rFSRP was computed at baseline for 19,309 participants (mean age = 72.84, SD = 8.48) from the NACC-UDS [9,697 (50.2%) normal cognition, 4,705 (24.4%) MCI, 4,907 (25.4%) dementia]. Multivariable linear, logistic, or ordinal regressions examined the association between the rFSRP and diagnostic status, neuropsychological test performance, CDR® Sum of Boxes, as well as total brain volume (TBV), hippocampal volume (HCV), and log-transformed white matter hyperintensities (WMH) for an MRI subset (n = 1,196). Models controlled for age, sex, education, racial identity, APOEɛ4 status, and estimated intracranial volume for MRI models. RESULTS: The mean rFSRP probability was 10.42% (min = 0.50%, max = 95.71%). Higher rFSRP scores corresponded to greater CDR Sum of Boxes (β= 0.02, p = 0.028) and worse performance on: Trail Making Test A (β= 0.05, p < 0.001) and B (β= 0.057, p < 0.001), and Digit Symbol (β= -0.058, p < 0.001). Higher rFSRP scores were associated with increased odds for a greater volume of log-transformed WMH (OR = 1.02 per quartile, p = 0.015). No associations were observed for diagnosis, episodic memory or language test scores, HCV, or TBV. CONCLUSION: These results support the rFSRP as a useful metric to facilitate clinical research on the associations between cerebrovascular disease and cognitive and brain aging.
Authors: Marilyn S Albert; Steven T DeKosky; Dennis Dickson; Bruno Dubois; Howard H Feldman; Nick C Fox; Anthony Gamst; David M Holtzman; William J Jagust; Ronald C Petersen; Peter J Snyder; Maria C Carrillo; Bill Thies; Creighton H Phelps Journal: Alzheimers Dement Date: 2011-04-21 Impact factor: 21.566
Authors: Michael L Alosco; Jonathan Duskin; Lilah M Besser; Brett Martin; Christine E Chaisson; John Gunstad; Neil W Kowall; Ann C McKee; Robert A Stern; Yorghos Tripodis Journal: J Alzheimers Dis Date: 2017 Impact factor: 4.472
Authors: Katherine J Bangen; Alexa Beiser; Lisa Delano-Wood; Daniel A Nation; Melissa Lamar; David J Libon; Mark W Bondi; Sudha Seshadri; Philip A Wolf; Rhoda Au Journal: J Stroke Cerebrovasc Dis Date: 2013-04-17 Impact factor: 2.136
Authors: Clinton B Wright; Joanne R Festa; Myunghee C Paik; Alexis Schmiedigen; Truman R Brown; Mitsuhiro Yoshita; Charles DeCarli; Ralph Sacco; Yaakov Stern Journal: Stroke Date: 2008-02-07 Impact factor: 7.914
Authors: Renske Uiterwijk; Julie Staals; Marjolein Huijts; Peter W de Leeuw; Abraham A Kroon; Robert J van Oostenbrugge Journal: J Clin Hypertens (Greenwich) Date: 2018-01-22 Impact factor: 3.738
Authors: Christian Puzo; Caroline Labriola; Michael A Sugarman; Yorghos Tripodis; Brett Martin; Joseph N Palmisano; Eric G Steinberg; Thor D Stein; Neil W Kowall; Ann C McKee; Jesse Mez; Ronald J Killiany; Robert A Stern; Michael L Alosco Journal: Alzheimers Res Ther Date: 2019-07-27 Impact factor: 6.982
Authors: Christopher A Lane; Josephine Barnes; Jennifer M Nicholas; Carole H Sudre; David M Cash; Thomas D Parker; Ian B Malone; Kirsty Lu; Sarah-Naomi James; Ashvini Keshavan; Heidi Murray-Smith; Andrew Wong; Sarah M Buchanan; Sarah E Keuss; Elizabeth Gordon; William Coath; Anna Barnes; John Dickson; Marc Modat; David Thomas; Sebastian J Crutch; Rebecca Hardy; Marcus Richards; Nick C Fox; Jonathan M Schott Journal: Lancet Neurol Date: 2019-08-20 Impact factor: 44.182