Physicians' Academy for Cardiovascular Education

Brain amyloid in later life increases with number of midlife vascular risk factors

Association Between Midlife Vascular Risk Factors and Estimated Brain Amyloid Deposition

Literature - Gottesman RF, Schneider ALC, Zhou Y, et al. - JAMA 2017;317(14):1443-1450


It becomes more evident that vascular risk factors are involved in the development of Alzheimer disease (AD) [1-4]. However, whether these risk factors can directly cause enhanced neurodegeneration that is specifically associated with AD, such as through increasing amyloid deposition, or lead to other cerebral changes, is unknown. Similarly, for the APOE Ɛ4 gene, which is known as a genetic risk factor for AD, though its role in the association between AD and vascular disease is unclear [5].

Brain amyloid can be measured using imaging biomarkers. In current study, the associations between vascular risk factors, APOE genotype and brain amyloid deposition were evaluated using data from participants of the ARIC study (Atherosclerosis Risk in Communities) of whom vascular risk factors (BMI ≥30/obesity, current smoking, hypertension, diabetes, total cholesterol ≥200 mg/dL) were collected for over 25 years and brain amyloid position PET imaging obtained in late life (n=322).

Main results


An increased number of midlife, but not late life vascular risk factors was associated with elevated brain amyloid in later life. The relationships between vascular risk factors and brain amyloid did not differ by race, nor by status of the APOE allele.


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