Cognitive impairment and p-tau217 are high in a vascular patient cohort

Scott R. French, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Juan C. Arias, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Summan Zahra, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Madeline Ally, Department of Psychology, University of Arizona, Tucson, Arizona, USA.
Cris Escareno, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Emma Heitkamp, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Franchell Vazquez, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Madison Hillis, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Haley Wiskoski, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Karthik Ainapurapu, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Gavin Culwell, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Caronae Howell, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Kevin Johnson, Department of Medical Imaging, University of Arizona, Tucson, Arizona, USA.
Cody Kraemer, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
John Pacanowski, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Luis Leon, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Scott Berman, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Federico Yanquez, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Joshua Balderman, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Joseph Sabat, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Olivia Hung, Department of Cardiovascular Medicine, Sarver Heart Center, University of Arizona College of Medicine, Tucson, Arizona, USA.
Layla Lucas, The Division of Vascular Surgery, University of Arizona, Tucson, Arizona, USA.
Francesca Vitali, Department of Neurology, University of Arizona, Tucson, Arizona, USA.
Edward J. Bedrick, Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona Health Sciences Center, Tucson, Arizona, USA.
Raza Mushtaq, Department of Neuroradiology, Barrow Neurological Institute, Phoenix, Arizona, USA.
Maria Altbach, Department of Medical Imaging, University of Arizona, Tucson, Arizona, USA.
Theodore P. Trouard, Department of Medical Imaging, University of Arizona, Tucson, Arizona, USA.
Fanny M. Elahi, Department of Neurology and Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Nicholas J. Ashton, Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Göteborg, Sweden.
Jeffrey L. Dage, Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Eric M. Reiman, Banner Alzheimer's Institute, Phoenix, Arizona, USA.

Document Type

Article

Abstract

INTRODUCTION: Vascular comorbidities are modifiable contributors to cognitive impairment and Alzheimer's disease (AD), yet brain health outcomes are rarely evaluated in cardiovascular patients. METHODS: This study prospectively evaluated cognition and AD pathology in 162 community-dwelling adults with asymptomatic cardiovascular disease who did not have a clinical diagnosis of dementia or cognitive impairment. RESULTS: Twenty-nine percent of the cohort had Montreal Cognitive Assessment (MoCA) scores indicative of cognitive impairment or dementia after adjusting for age, sex, and education based on National Alzheimer's Coordinating Center normative data. AD blood biomarker phosphorylated tau217 was elevated in 55% of the cohort, significantly associated with decreased MoCA scores (β = -1.46, 95% confidence interval [CI] -2.53 to -0.39, p < 0.01), and accurately differentiated cognitive impairment (area under the curve 0.94, 95% CI 0.88-0.99). DISCUSSION: This level of undiagnosed cognitive impairment and AD pathology exceeds what would be expected in the general population and highlights a potential need for screening and future work to better identify treatment options. HIGHLIGHTS: Brain health outcomes are rarely evaluated in vascular patients. One hundred sixty-two adults with asymptomatic cardiovascular disease but without diagnoses of cognitive impairment or dementia were evaluated. Phosphorylated tau217 accurately differentiated cognitive impairment in patients with cardiovascular disease. High levels of cognitive impairment and Alzheimer's disease pathology are greatly underdiagnosed in the cardiovascular population.

Medical Subject Headings

Humans; Female; Male; Cognitive Dysfunction (blood, diagnosis); tau Proteins (blood); Aged; Biomarkers (blood); Cohort Studies; Alzheimer Disease (blood); Mental Status and Dementia Tests (statistics & numerical data); Cardiovascular Diseases (complications, blood); Prospective Studies; Phosphorylation; Middle Aged; Aged, 80 and over; Neuropsychological Tests

Publication Date

8-1-2025

Publication Title

Alzheimer's & dementia : the journal of the Alzheimer's Association

E-ISSN

1552-5279

Volume

21

Issue

8

First Page

e70565

PubMed ID

40772428

Digital Object Identifier (DOI)

10.1002/alz.70565

Link to Full Text

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