Linking Vascular Cognitive Impairment and Alzheimer Disease Risk in Midlife

Background Vascular cognitive impairment is a decline in cognitive skills caused by conditions that block or reduce blood flow to various regions of the brain, depriving them of oxygen and nutrients. Individuals with dementia may have impairment characteristic of both Alzheimer's and cerebrovascular (brain blood vessel) disease.The role of cerebrovascular disease in Alzheimer's and other dementias is particularly relevant among diverse racial and ethnic populations. In the United States, individuals from these groups typically have increased vascular disease risk. Additionally, according to the 2022 Alzheimer's Association Facts and Figures report, older Black/ African American and Hispanic/ Latino Americans are disproportionately more likely than older White Americans to have Alzheimer's or other dementias. These differences in risk are thought to be due to health related disparities for older Black/ African American and Hispanic/ Latino populations compared with older white populations. Examining these factors in midlife, before cognitive symptoms occur, is critical because midlife health is associated with cognitive decline and Alzheimer's later in life.Research PlanDr. Adam Brickman and colleagues will study how biological markers (biomarkers) of vascular cognitive impairment are associated with cognitive and brain changes across diverse populations. They will use data from The Offspring Study, a long-term study of cognitive aging and dementia risk in middle aged adults in Manhattan, New York. Participants will include individuals who identify as white, Black, and Latinx and are willing to contribute blood samples, undergo brain scans (magnetic resonance imaging, MRI), and neuropsychological assessments at multiple time points throughout the study. Dr. Brickman and team will examine the relationships between biomarkers of vascular cognitive impairment, cognitive decline, brain changes, and biomarkers of Alzheimer's. The researchers will also investigate how these factors are linked to race/ethnicity, sex/gender, and other determinants of health (e.g., education level, experience of discrimination, and socioeconomic status).ImpactIf successful, this study may increase our understanding of the role of cerebrovascular factors in the development of Alzheimer's and other dementias, particularly in racial and ethnic groups most at risk.