Comorbid amyloid-β pathology affects clinical and imaging features in VCD

Alzheimers Dement. 2020 Feb;16(2):354-364. doi: 10.1016/j.jalz.2019.08.190. Epub 2020 Jan 4.


Introduction: To date, the clinical relevance of comorbid amyloid-β (Aβ) pathology in patients with vascular cognitive disorders (VCD) is largely unknown.

Methods: We included 218 VCD patients with available cerebrospinal fluid Aβ42 levels. Patients were divided into Aβ+ mild-VCD (n = 84), Aβ- mild-VCD (n = 68), Aβ+ major-VCD (n = 31), and Aβ- major-VCD (n = 35). We measured depression with the Geriatric Depression Scale, cognition with a neuropsychological test battery and derived white matter hyperintensities (WMH) and gray matter atrophy from MRI.

Results: Aβ- patients showed more depressive symptoms than Aβ+. In the major-VCD group, Aβ- patients performed worse on attention (P = .02) and executive functioning (P = .008) than Aβ+. We found no cognitive differences in patients with mild VCD. In the mild-VCD group, Aβ- patients had more WMH than Aβ+ patients, whereas conversely, in the major-VCD group, Aβ+ patients had more WMH. Atrophy patterns did not differ between Aβ+ and Aβ- VCD group.

Discussion: Comorbid Aβ pathology affects the manifestation of VCD, but effects differ by severity of VCD.

Keywords: Amyloid-β; Cognition; Gray matter atrophy; MRI; Vascular cognitive disorders; Vascular dementia; White matter hyperintensities.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Amyloid beta-Peptides* / cerebrospinal fluid
  • Amyloid beta-Peptides* / classification
  • Cognition Disorders / pathology*
  • Dementia, Vascular / diagnostic imaging
  • Dementia, Vascular / pathology*
  • Executive Function
  • Female
  • Gray Matter / pathology
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Neuropsychological Tests / statistics & numerical data
  • Retrospective Studies
  • Severity of Illness Index
  • White Matter / pathology


  • Amyloid beta-Peptides