Abstract：
Cerebrovascular disease (CVD) and Alzheimer\'s disease (AD) often co-occur and may impact specific cognitive domains. This study\'s goal was to determine effects of CVD and AD burden on cross-sectional and longitudinal executive function (EF) and memory in older adults. Longitudinally followed participants from the National Alzheimer Coordinating Center database (n = 3342) were included. Cognitive outcomes were EF and memory composite scores. Baseline CVD presence was defined by moderate-to-severe white matter hyperintensities or lacunar infarct on MRI. Baseline AD pathology was defined by amyloid positivity via PET or CSF. Linear mixed models examined effects of CVD, AD, and time on cognitive outcomes, controlling for sex, education, baseline age, MoCA score, and total number of study visits. At baseline, CVD associated with lower EF (p < 0.001), while AD associated with lower EF and memory (ps < 0.001). Longitudinally only AD associated with faster declines in memory and EF (ps < 0.001). These results extend our understanding of CVD and AD pathology, highlighting that CVD does not necessarily indicate accelerated decline.
摘要：
脑血管疾病（CVD）和阿尔茨海默病（AD）经常同时发生，并可能影响特定的认知领域。本研究的目的是确定CVD和AD负担对老年人横断面和纵向执行功能（EF）和记忆的影响。包括来自国家阿尔茨海默病协调中心数据库的纵向随访参与者（n=3342）。认知结果是EF和记忆综合评分。基线CVD的存在通过MRI上的中度至重度白质高信号或腔隙性梗塞来定义。基线AD病理学通过经由PET或CSF的淀粉样蛋白阳性来定义。线性混合模型检查了CVD的影响，AD,和认知结果的时间，控制性，教育,基线年龄,MoCA得分,以及研究访问的总次数。在基线,与较低EF相关的CVD（p<0.001），而AD与较低的EF和记忆相关(ps<0.001)。仅纵向AD与记忆和EF的更快下降相关(ps<0.001)。这些结果扩展了我们对CVD和AD病理学的理解,强调CVD并不一定表明加速下降。
