Vascular Contributions to Mechanisms and Biomarkers of Alzheimer’s Disease

  • STATUS
    Recruiting
  • End date
    Jul 31, 2025
Updated on 9 September 2022
cognitive impairment
cognitive decline
mild cognitive impairment
Accepts healthy volunteers

Summary

This study is managed by Temple University Alzheimer’s Center in collaboration with Crozer Keystone Health System. NO drug involved


The study will evaluate longitudinally whether the presence of cardiovascular (CV) risk factors (particularly hypertension and hyperhomocysteinemia), in an age and gender-matched population including cognitive normal, subjects with mild cognitive impairment (MCI) and Alzheimer's disease, contributes to the progression of cognitive decline, and assess whether changes in MRI measures and blood biomarkers associated with neurovascular dysfunction correlate with the cognitive outcome. In addition, the study will evaluate whether the presence of CV risk factors contributes longitudinally to the progression of cognitive decline based on cognitive assessment scores. We will also assess whether blood biomarkers associated with vascular, neuronal and glial/inflammatory changes in the brain, and MRI measures, correlate longitudinally with cognitive scores, psychosocial state, as well as with each other, and whether the presence of CV risk factors contributes to the observed biomarker changes.

Description

We will evaluate longitudinally whether the presence of cardiovascular (CV) risk factors (particularly hypertension, HT and hyperhomocysteinemia, HHcy), in an age and gender-matched population including cognitive normal, subjects with mild cognitive impairment (MCI) and AD, contributes to the progression of cognitive decline, and assess whether changes in MRI measures and blood biomarkers associated with neurovascular dysfunction correlate with the cognitive outcome.
We will recruit and enroll at the Crozer Keystone Center for Geriatric Medicine a cohort of age and gender-matched cognitive normal (NL), MCI and AD individuals. All participants will undergo the Montreal Cognitive Assessment (MoCA) and Mini-Mental State Exam (MMSE), psychosocial tests, a blood draw to collect plasma and serum at recruitment (baseline), as well as after 1 and 2 years, and an MRI scan at year 1 and year 2. Novel and established blood biomarkers of AD and neurovascular dysfunction will be measured at the 3 time points using a state of the art high sensitivity approach (Quanterix Simoa). MRI measures will include gray matter volumes, hippocampal segmentation as well as analysis of white matter abnormalities.
We will evaluate whether the presence of CV risk factors contributes longitudinally to the progression of cognitive decline based on the MoCA and MMSE scores.
We will assess whether blood biomarkers associated with vascular, neuronal and glial/inflammatory changes in the brain, and MRI measures, correlate longitudinally with MoCA and MMSE cognitive scores, psychosocial state, as well as with each other, and whether the presence of CV risk factors contributes to the observed biomarker changes.
Over the normal life span and over time, and in particular in presence of MCI and AD, hippocampal and cortical atrophy rates and plasma biomarkers associated with neurovascular degeneration increase, while memory performance decreases.
We hypothesize that the presence of CV risk factors will contribute to worsening of memory, impaired psychosocial activity, and changes in blood and imaging biomarkers associated with neuronal and vascular dysfunction in elderly cognitively normal, MCI and AD subjects.
This aim will allow us to characterize the contribution of CV risk to the longitudinal rates of cognitive performance, plasma biomarker expression, hippocampal and cortical atrophy, and cerebrovascular imaging complications in elderly and AD.
We propose to examine150 gender-matched individuals between the ages of 60-90 years (50 NL, 50 MCI, 50 AD), of whom about ½ will present CV risk factors (HT and/or HHcy), longitudinally studied over a 2-years period. Each person recruited will be subjected to 3 (baseline, 1 year and 2 years) clinical and psychometric evaluations at least two research-quality MRI scans (baseline and 2 years). Blood draws will be obtained for all these subjects at each examination (0, 1, and 2 years) for clinical lab assessments, as well as to obtain plasma and serum for biomarker analysis.

Details
Condition Alzheimer's Disease, Mild Cognitive Impairment
Clinical Study IdentifierTX299828
Last Modified on9 September 2022

Eligibility

Yes No Not Sure

Inclusion Criteria

All subjects between 60-90 years at baseline examination, with clinical and neuropsychological examinations and who accept to complete follow-up examinations at year 1 and 2 with MRI scan (year 1 and year 2) and blood sampling (baseline, year 1, and year 2)
All subjects will need to agree to ApoE genotyping and DNA banking

Exclusion Criteria

History or MRI evidence of brain damage including, brain masses, hydrocephalus, seizures, mental retardation or serious neurological disorder, clinical history of stroke with neurological symptoms. Periventricular or deep white matter lesions on MRI will not trigger exclusion, as these lesions are common in elderly, non-demented or demented individuals
History of psychiatric illness (e.g., schizophrenia, mania, PTSD, or depression)
Significant history of alcoholism or drug abuse
A total score of 8 or more on the cognitive assessments to exclude possible cases of primary depression
Physical impairment of such severity as to adversely affect the validity of psychological testing
Hostility or refusal to cooperate
Any prosthetic devices (e.g., pacemaker or surgical clips) that could interfere with MRI imaging (participants can be retained for clinical and blood tests but will be excluded from MRI)
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