Cerebral Amyloid Angiopathy in Patients with Cognitive Impairment: Cerebrospinal Fluid Biomarkers

Abstract

<b><i>Introduction:</i></b> Cerebral amyloid angiopathy (CAA) is characterized by amyloid β (Aβ) deposition in brain vessels, leading to hemorrhagic phenomena and cognitive impairment. Magnetic resonance imaging (MRI)-based criteria allow a diagnosis of probable CAA in vivo, but such a diagnosis cannot predict the eventual development of CAA. <b><i>Methods:</i></b> We conducted a retrospective cohort study of 464 patients with cognitive disorders whose data were included in a brain health biobank. De-identified parameters including sex, age, cognitive score, APOE status, and cerebrospinal fluid (CSF) levels of Aβ 1–40, Aβ 1–42, phosphorylated tau, and total tau were assessed in those with and without CAA. Odds ratios (ORs) and 95% confidence intervals (CIs) were determined. <b><i>Results:</i></b> CAA was present in 53 of 464 (11.5%) patients. P-tau level was significantly higher in those with CAA (115 vs. 84.3 pg/mL <i>p</i> = 0.038). In univariate analyses, the risk of developing CAA was higher with increased age (OR, 1.036; 95% CI: 1.008, 1.064; <i>p</i> = 0.011) and decreased CSF level of Aβ 1–40 (OR, 0.685; 95% CI: 0.534, 0.878; <i>p</i> = 0.003). In multivariate analyses, the risk of CAA remained higher with a decreased CSF level of Aβ 1–40 (OR, 0.681; 95% CI: 0.531, 0.874; <i>p</i> = 0.003). <b><i>Conclusion:</i></b> These findings suggest that Aβ 1–40 levels in the CSF might be a useful molecular biomarker of CAA in patients with dementia.