Association Between Vascular Measures and MRI Biomarkers in Individuals with Mild Cognitive Impairment: The VASCULAR Study Público
Ramakrishnan, Manju (Spring 2025)
Abstract
Background:
Vascular dysfunction is increasingly implicated in the early development of Alzheimer’s disease (AD) and related dementias. Mild cognitive impairment (MCI), often preceding AD, provides a critical window to examine vascular contributions to early neurodegeneration. This study explores the associations between noninvasive vascular measures and MRI-derived brain biomarkers in older adults with and without MCI.
Methods:
Data were drawn from the VASCULAR study, a prospective observational cohort of adults aged ≥50. Vascular health was assessed using the reactive hyperemia index (RHI) and carotid intima-media thickness (CIMT). Brain structure was evaluated using MRI-derived hippocampal volumes and white matter hypointensities. Analyses included group comparisons and linear models stratified by cognitive status.
Results:
Among 127 participants (mean age of 63.9 years; 66% female), 39 had MCI and 88 had normal cognition. The MCI group had lower educational attainment and higher obesity prevalence. Compared to those with normal cognition, individuals with MCI had lower RHI (median: 1.80 vs. 2.17; p = 0.007) and higher right CIMT (0.76 mm vs. 0.71 mm; p = 0.032), indicating worse endothelial function and more subclinical atherosclerosis. They also exhibited smaller bilateral hippocampal volumes. Left CIMT was positively associated with white matter hypointensities (β = 0.98, 95% CI: 0.05 to 1.90, p = 0.04).
Conclusion:
Vascular dysfunction is linked to structural brain changes in MCI, underscoring its potential role in early cognitive decline. Noninvasive vascular assessments may aid in identifying individuals at heightened risk and inform midlife public health interventions.
Table of Contents
Abstract 1
Introduction 2
Methods 5
Study Design and Participants 5
Covariates and Exposures of interest 5
Outcomes 6
Statistical Analysis 7
Results 9
Demographics and Clinical Characteristics of participants 9
Vascular and MRI measures in participants 9
Association of Vascular and MRI measures in participants (Regression Analysis) 10
Discussion 10
Limitations 13
Conclusion and Future Directions 14
References 15
Tables
Table 1: Demographic and Clinical Characteristics by Cognitive Status 21
Table 2. Vascular and MRI Measures by Cognition Status 24
Table 3. Association of RHI and MRI Outcomes 25
Table 4. Association of Mean Right Carotid CIMT and MRI Outcomes 26
Table 5. Association of Mean Left Carotid CIMT and MRI Outcomes 27
Figures
Figure 1. Distribution of RHI by Cognition Status 28
Figure 2. Distribution of Right CIMT by Cognition Status 28
Figure 3. Distribution of Left CIMT by Cognition Status 29
Figure 4. Distribution of Right Hippocampal Volume by Cognition Status 29
Figure 5. Distribution of Left Hippocampal Volume by Cognition Status 30
Figure 6. Distribution of White Matter Hypointensities by Cognition Status 30
Figure 7. Spearman Correlation Heat Map (ρ) 31
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