Prevalence of cerebral amyloid angiopathy and its correlation with Alzheimer's disease and cognition in an autopsy-confirmed cohort from China

Abstract

BACKGROUND: We aimed to investigate the prevalence of cerebral amyloid angiopathy (CAA) and its correlations with Alzheimer's disease (AD) and cognitive impairment in an autopsy-confirmed cohort donated to a human brain bank in Beijing, China. METHODS: A total of 483 subjects were neuropathologically evaluated based on standardized protocols. Descriptive statistics and ordinal logistic regression models were used to estimate the correlation between CAA, AD, apolipoprotein E (APOE) genotyping, and cognitive function proximal to death. RESULTS: Neuropathological assessment revealed that 53 of 483 subjects (11%) had CAA without AD, 78 of 483 (16%) had AD without CAA, 98 of 483 (20%) had both CAA and AD, and 254 of 483 (53%) had neither condition. A significant correlation was confirmed between CAA severity and AD. Subjects with both CAA and AD exhibited aggravated cognitive impairment. DISCUSSION: Our results indicate a substantial prevalence of CAA that is frequently comorbid with AD and may exacerbate cognitive decline in the elderly population in China. Highlights: First reporting of cerebral amyloid angiopathy (CAA) based on an autopsy-confirmed cohort from China. The prevalence of CAA was high in the elderly Chinese sample. Age and apolipoprotein E (APOE) ε4 allele were related to the prevalence of CAA. CAA and Alzheimer's disease (AD) were frequently co-occurred and significantly associated. Subjects with both CAA and AD exhibited aggravated cognitive impairment.