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Age, vascular health, and Alzheimer disease biomarkers in an elderly sample
Vemuri P, Lesnick TG, Przybelski SA, Knopman DS, Lowe VJ, Graff-Radford J, Roberts RO, Mielke MM et al.. Annals of neurology, 2017-10-26
Topic: Amyloid, tau and blood-test diagnosis
Objective To investigate the associations between age, vascular health, and Alzheimer disease (AD) imaging biomarkers in an elderly sample. Methods We identified 430 individuals along the cognitive continuum aged >60 years with amyloid positron emission tomography (PET), tau PET, and magnetic resonance imaging (MRI) scans from the population-based Mayo Clinic Study of Aging. A subset of 329 individuals had fluorodeoxyglucose (FDG) PET. We ascertained presently existing cardiovascular and metabolic conditions (CMC) from health care records and used the summation of presence/absence of hypertension, hyperlipidemia, cardiac arrhythmias, coronary artery disease, congestive heart failure, diabetes mellitus, and stroke as a surrogate for vascular health. We used global amyloid from Pittsburgh compound B PET, entorhinal cortex tau uptake (ERC-tau) from tau-PET, and neurodegeneration in AD signature regions from MRI and FDG-PET as surrogates for AD pathophysiology. We dichotomized participants into CMC = 0 (CMC - ) versus CMC > 0 (CMC + ) and tested for age-adjusted group differences in AD biomarkers. Using structural equation models (SEMs), we assessed the impact of vascular health on AD biomarker cascade (amyloid leads to tau leads to neurodegeneration) after considering the direct and indirect age, sex, and apolipoprotein E effects. Results CMC + participants had significantly greater neurodegeneration than CMC - participants but did not differ by amyloid or ERC-tau. The SEMs showed that (1) vascular health had a significant direct and indirect impact on neurodegeneration but not on amyloid; and (2) vascular health, specifically the presence of hyperlipidemia, had a significant direct impact on ERC-tau. Interpretation Vascular health had quantifiably greater impact on neurodegeneration in AD regions than on amyloid deposition. Longitudinal studies are warranted to clarify the relationship between tau deposition and vascular health. Ann Neurol 2017;82:706-718.
Key findings
- We dichotomized participants into CMC = 0 (CMC - ) versus CMC > 0 (CMC + ) and tested for age-adjusted group differences in AD biomarkers.
- Results CMC + participants had significantly greater neurodegeneration than CMC - participants but did not differ by amyloid or ERC-tau.
- The SEMs showed that (1) vascular health had a significant direct and indirect impact on neurodegeneration but not on amyloid; and (2) vascular health, specifically the presence of hyperlipidemia, had a significant direct impact on ERC-tau.
Why it matters
In 430 adults over 60 from the Mayo Clinic Study of Aging, people with at least one cardiovascular or metabolic condition (such as high blood pressure, high cholesterol, diabetes or stroke) showed more brain-tissue loss on scans. Their levels of amyloid or entorhinal tau were no different from people without those conditions. In the study's models, vascular health was linked to neurodegeneration but not to amyloid, and high cholesterol specifically was linked to entorhinal tau. This is an observational imaging study that counted diagnoses from health records; it did not test whether treating these conditions changes Alzheimer's.
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Study details
- Study designlongitudinal study
- Participants430
- Evidence strengthModerate
How this study scored 64/100
Published in a leading specialty journal, and it is a longitudinal study following the same people over time. Scored zero for effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Annals of neurology) |
| Journal's citation record | 3 / 4 | Annals of Neurology: journal h-index 437 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A longitudinal study following the same people over time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2017 — within 10 year(s) of the newest study here |
| Sample size | 2 / 4 | 430 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 182 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 16.5 citations a year over 11 year(s) since 2017 |
| Impact for its field and year | 4 / 6 | Cited 14.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 15 other studies in this library |
| Still being cited | 2 / 4 | Cited 40 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Clifford R. Jack: h-index 203 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | Mayo Clinic: institution h-index 1,606 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 29023983) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 64 / 100 | — |
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Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Vemuri, P., Lesnick, T. G., Przybelski, S. A., Knopman, D. S., Lowe, V. J., Graff-Radford, J., et al. (2017). Age, vascular health, and Alzheimer disease biomarkers in an elderly sample. Annals of neurology. https://doi.org/10.1002/ana.25071
Vancouver
Vemuri P, Lesnick TG, Przybelski SA, Knopman DS, Lowe VJ, Graff-Radford J, et al. Age, vascular health, and Alzheimer disease biomarkers in an elderly sample. Annals of neurology. 2017. doi:10.1002/ana.25071. PMID: 29023983.
BibTeX
@article{vemuri2017-29023983,
author = {Vemuri, P. and Lesnick, T. G. and Przybelski, S. A. and Knopman, D. S. and Lowe, V. J. and Graff-Radford, J. and Roberts, R. O. and Mielke, M. M. and others},
title = {{Age, vascular health, and Alzheimer disease biomarkers in an elderly sample}},
journal = {Annals of neurology},
year = {2017},
doi = {10.1002/ana.25071},
pmid = {29023983},
url = {https://doi.org/10.1002/ana.25071}
}
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