Cerebral amyloid angiopathy (CAA) in dementia cohort‐ biomarkers

Background

Cerebral amyloid angiopathy (CAA) defined as deposition of amyloid β‐protein (Aβ) in brain vessels, leads to hemorrhagic phenomena and cognitive impairment. As a disease with Aβ deposition, CAA is commonly compared to Alzheimer’s disease (AD). Imaging‐based Boston criteria allow a diagnosis of probable CAA in vivo, but cannot predict the development of CAA thus development of reliable biomarkers is necessary.

Recognizing the potential risks of CAA in patients with dementia is of great importance in the context of emerging accessibility of anti‐Aβ immunotherapy. Clinicians will be balancing the risks and benefits of such therapy for their Patients with Alzheimer’s disease on daily basis. This situation calls for developing better biomarkers of cerebral amyloid angiopathy.

Method

Presented here a retrospective cohort study of 463 bio‐banked patients with cognitive disorders. De‐identified parameters like sex, age, MOCA, APOE; CSF levels: Aβ 1‐40, Aβ 1‐42, p and t Tau were correlated with the signs of CAA (as assessed by MRI).

Results

CAA was present in 53 out of 463 (11.5%) of the examined population with different types of dementia. 33% of those with CAA were diagnosed with Alzheimer’s disease; 38% with Vascular dementia;23% with MCI‐amnestic; 4% with MCI‐non‐amnestic; 2% with Lewy Body Dementia. Age and level of Amyloid beta 1‐40 were significantly associated with the occurrence of CAA, . An increase in age will increase the odds of developing CAA. From all the other parameters analyzed, the odds of CAA were linked to the low CSF level of Amyloid beta 1‐40.

Conclusion

Low CSF level of Amyloid beta 1‐40 may be considered a biomarker of CAA in dementia.