The association between electrophysiological and neuropsychological measures and cardiovascular disease in patients with Alzheimer’s Disease dementia

Abstract

AbstractBackgroundElectrophysiological and neuropsychological measures are useful markers of Alzheimer’s Disease (AD); however, it is still unclear how these measures relate to the cardiovascular profile of AD patients, and their influence on disease progression and management. Our study examined how electrophysiological and neuropsychological measures are associated with cardiovascular risk factors and the severity of small vessel disease among patients with AD dementia.MethodData were collected using a seven‐electrode COGNISION™ rig in 185 older veterans from the VA Boston Healthcare system memory disorders clinic. EEG/ERP data were recorded while participants completed a three‐tone auditory oddball task. All subjects were administered a neuropsychological battery composed of 8 subtests. Through review of medical history, we selected a subset of patients (N = 46) that met the following criteria: core clinical criteria for probable AD dementia, ≥ 65 years of age, and MMSE score between 20 and 26. We categorized these patients based on their number of cardiovascular risk factors—among hypertension, type 2 diabetes or prediabetes, hypercholesterolemia, and body mass index (BMI) ≥ 25 kg/m2 —and their small vessel disease severity (absent, mild, moderate, or severe). Spearman correlations were computed to assess the association of electrophysiological and neuropsychological measures with the number of cardiovascular risk factors and the severity of small vessel disease.ResultAlpha peak frequency was positively correlated with the number of cardiovascular risk factors (p = .011) and was inversely correlated with small vessel disease severity (p = .029). N100 standard latency was inversely correlated with small vessel disease severity (p = .018). Scores on the verbal phonemic fluency test were inversely correlated with the number of cardiovascular risk factors (p = .014), while scores on the verbal category fluency test were inversely correlated with small vessel disease severity (p = .023).ConclusionAlpha peak frequency, N100, and verbal fluency scores are associated with the number of cardiovascular risk factors and small vessel disease severity in AD patients. Overall, these electrophysiological and neuropsychological measures represent a clinical tool to help characterize the cardiovascular profile of patients with AD dementia, and its contribution to overall disease progression.