Blood‐brain barrier permeability and risk of conversion to dementia in patients with mild cognitive impairment

Blood‐brain barrier permeability and risk of conversion to dementia in patients with mild cognitive impairment

Background Cardiovascular risk factors (CVRF) have been associated with an increased risk of cognitive decline and dementia. Increase of blood‐brain barrier permeability (BBBp) measured by CSF/serum albumin ratio (Qalb) have been associated with CVRF. The aim of this study was to analyze the possibl...

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Veröffentlicht in:Alzheimer's & dementia 2023-12, Vol.19 (S15), p.n/a
Hauptverfasser: Puig‐Pijoan, Albert, Fernández‐Lebrero, Aida, Garcia‐Escobar, Greta, Navalpotro‐Gómez, Irene, Manero‐Borr, Rosa Maria, Contador, José, Suárez‐Pérez, Antoni, Puente‐Periz, Víctor, Grau‐Rivera, Oriol, Suarez‐Calvet, Marc, Jimenez‐Balado, Joan, Roquer, Jaume, Ois, Angel
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container_end_page n/a
container_issue S15
container_start_page
container_title Alzheimer's & dementia
container_volume 19
creator Puig‐Pijoan, Albert
Fernández‐Lebrero, Aida
Garcia‐Escobar, Greta
Navalpotro‐Gómez, Irene
Manero‐Borr, Rosa Maria
Contador, José
Suárez‐Pérez, Antoni
Puente‐Periz, Víctor
Grau‐Rivera, Oriol
Suarez‐Calvet, Marc
Jimenez‐Balado, Joan
Roquer, Jaume
Ois, Angel
description Background Cardiovascular risk factors (CVRF) have been associated with an increased risk of cognitive decline and dementia. Increase of blood‐brain barrier permeability (BBBp) measured by CSF/serum albumin ratio (Qalb) have been associated with CVRF. The aim of this study was to analyze the possible role of Qalb as a predictor of conversion to dementia in patients with mild cognitive impairment (MCI). Method A total of 144 individuals with MCI were recruited from the BIODEGMAR cohort at Hospital del Mar (Barcelona) from 2017 to 2021. Study protocol included neuropsychological assessment, blood sampling, lumbar puncture and brain MRI. Follow‐up visits were performed yearly (12 +‐2 months) until January 2023. The endpoint of the study was a diagnosis of dementia (Global Deterioration Scale –GDS‐ > 3 and/or Clinical Dementia Rating ‐CDR‐ score > 0.5). BBBp was measured by CSF/serum albumin ratio (Qalb). Azheimer’s Disease (AD) was biologically‐defined according to CSF Aβ42/p‐tau ratio (AD+/‐). A composite vascular score (CVS) was calculated by assigning one point for the presence of each of the following CVRF (hypertension, hyperlipidemia and diabetes mellitus) plus another point if Fazekas scale higher than 1 or presence of brain infarcts on MRI. We performed a multivariate Cox regression analysis including the following variables: age, sex, AD and CVS. Result Sixty‐two cases (39.2%) developed dementia in a median follow‐up of 25.89 +/‐ 13.98 months. Univariate analysis showed that Qalb (p < 0.01), AD+ (p < 0.01) and CVS (p = 0.016) were associated with dementia. The regression model results showed an independent relationship between conversion to dementia and Qalb, HR = 1.333 (95% CI 1.185‐1.499) and AD+, HR = 4.118 (2.202‐7.699). Conclusion An increase in BBBp was independently associated with a higher risk of conversion to dementia in MCI patients. This result points to a potential role of Qalb as a useful biomarker of clinical prognosis of MCI patients.
doi_str_mv 10.1002/alz.077089
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ERA‐CVD Transnational Call</creatorcontrib><description>Background Cardiovascular risk factors (CVRF) have been associated with an increased risk of cognitive decline and dementia. Increase of blood‐brain barrier permeability (BBBp) measured by CSF/serum albumin ratio (Qalb) have been associated with CVRF. The aim of this study was to analyze the possible role of Qalb as a predictor of conversion to dementia in patients with mild cognitive impairment (MCI). Method A total of 144 individuals with MCI were recruited from the BIODEGMAR cohort at Hospital del Mar (Barcelona) from 2017 to 2021. Study protocol included neuropsychological assessment, blood sampling, lumbar puncture and brain MRI. Follow‐up visits were performed yearly (12 +‐2 months) until January 2023. The endpoint of the study was a diagnosis of dementia (Global Deterioration Scale –GDS‐ &gt; 3 and/or Clinical Dementia Rating ‐CDR‐ score &gt; 0.5). BBBp was measured by CSF/serum albumin ratio (Qalb). Azheimer’s Disease (AD) was biologically‐defined according to CSF Aβ42/p‐tau ratio (AD+/‐). A composite vascular score (CVS) was calculated by assigning one point for the presence of each of the following CVRF (hypertension, hyperlipidemia and diabetes mellitus) plus another point if Fazekas scale higher than 1 or presence of brain infarcts on MRI. We performed a multivariate Cox regression analysis including the following variables: age, sex, AD and CVS. Result Sixty‐two cases (39.2%) developed dementia in a median follow‐up of 25.89 +/‐ 13.98 months. Univariate analysis showed that Qalb (p &lt; 0.01), AD+ (p &lt; 0.01) and CVS (p = 0.016) were associated with dementia. The regression model results showed an independent relationship between conversion to dementia and Qalb, HR = 1.333 (95% CI 1.185‐1.499) and AD+, HR = 4.118 (2.202‐7.699). Conclusion An increase in BBBp was independently associated with a higher risk of conversion to dementia in MCI patients. This result points to a potential role of Qalb as a useful biomarker of clinical prognosis of MCI patients.</description><identifier>ISSN: 1552-5260</identifier><identifier>EISSN: 1552-5279</identifier><identifier>DOI: 10.1002/alz.077089</identifier><language>eng</language><ispartof>Alzheimer's &amp; dementia, 2023-12, Vol.19 (S15), p.n/a</ispartof><rights>2023 the Alzheimer's Association.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Falz.077089$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Falz.077089$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids></links><search><creatorcontrib>Puig‐Pijoan, Albert</creatorcontrib><creatorcontrib>Fernández‐Lebrero, Aida</creatorcontrib><creatorcontrib>Garcia‐Escobar, Greta</creatorcontrib><creatorcontrib>Navalpotro‐Gómez, Irene</creatorcontrib><creatorcontrib>Manero‐Borr, Rosa Maria</creatorcontrib><creatorcontrib>Contador, José</creatorcontrib><creatorcontrib>Suárez‐Pérez, Antoni</creatorcontrib><creatorcontrib>Puente‐Periz, Víctor</creatorcontrib><creatorcontrib>Grau‐Rivera, Oriol</creatorcontrib><creatorcontrib>Suarez‐Calvet, Marc</creatorcontrib><creatorcontrib>Jimenez‐Balado, Joan</creatorcontrib><creatorcontrib>Roquer, Jaume</creatorcontrib><creatorcontrib>Ois, Angel</creatorcontrib><creatorcontrib>CardioStressCI Consortium. ERA‐CVD Transnational Call</creatorcontrib><title>Blood‐brain barrier permeability and risk of conversion to dementia in patients with mild cognitive impairment</title><title>Alzheimer's &amp; dementia</title><description>Background Cardiovascular risk factors (CVRF) have been associated with an increased risk of cognitive decline and dementia. Increase of blood‐brain barrier permeability (BBBp) measured by CSF/serum albumin ratio (Qalb) have been associated with CVRF. The aim of this study was to analyze the possible role of Qalb as a predictor of conversion to dementia in patients with mild cognitive impairment (MCI). Method A total of 144 individuals with MCI were recruited from the BIODEGMAR cohort at Hospital del Mar (Barcelona) from 2017 to 2021. Study protocol included neuropsychological assessment, blood sampling, lumbar puncture and brain MRI. Follow‐up visits were performed yearly (12 +‐2 months) until January 2023. The endpoint of the study was a diagnosis of dementia (Global Deterioration Scale –GDS‐ &gt; 3 and/or Clinical Dementia Rating ‐CDR‐ score &gt; 0.5). BBBp was measured by CSF/serum albumin ratio (Qalb). Azheimer’s Disease (AD) was biologically‐defined according to CSF Aβ42/p‐tau ratio (AD+/‐). A composite vascular score (CVS) was calculated by assigning one point for the presence of each of the following CVRF (hypertension, hyperlipidemia and diabetes mellitus) plus another point if Fazekas scale higher than 1 or presence of brain infarcts on MRI. We performed a multivariate Cox regression analysis including the following variables: age, sex, AD and CVS. Result Sixty‐two cases (39.2%) developed dementia in a median follow‐up of 25.89 +/‐ 13.98 months. Univariate analysis showed that Qalb (p &lt; 0.01), AD+ (p &lt; 0.01) and CVS (p = 0.016) were associated with dementia. The regression model results showed an independent relationship between conversion to dementia and Qalb, HR = 1.333 (95% CI 1.185‐1.499) and AD+, HR = 4.118 (2.202‐7.699). Conclusion An increase in BBBp was independently associated with a higher risk of conversion to dementia in MCI patients. 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ERA‐CVD Transnational Call</creatorcontrib><collection>CrossRef</collection><jtitle>Alzheimer's &amp; dementia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Puig‐Pijoan, Albert</au><au>Fernández‐Lebrero, Aida</au><au>Garcia‐Escobar, Greta</au><au>Navalpotro‐Gómez, Irene</au><au>Manero‐Borr, Rosa Maria</au><au>Contador, José</au><au>Suárez‐Pérez, Antoni</au><au>Puente‐Periz, Víctor</au><au>Grau‐Rivera, Oriol</au><au>Suarez‐Calvet, Marc</au><au>Jimenez‐Balado, Joan</au><au>Roquer, Jaume</au><au>Ois, Angel</au><aucorp>CardioStressCI Consortium. ERA‐CVD Transnational Call</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Blood‐brain barrier permeability and risk of conversion to dementia in patients with mild cognitive impairment</atitle><jtitle>Alzheimer's &amp; dementia</jtitle><date>2023-12</date><risdate>2023</risdate><volume>19</volume><issue>S15</issue><epage>n/a</epage><issn>1552-5260</issn><eissn>1552-5279</eissn><abstract>Background Cardiovascular risk factors (CVRF) have been associated with an increased risk of cognitive decline and dementia. Increase of blood‐brain barrier permeability (BBBp) measured by CSF/serum albumin ratio (Qalb) have been associated with CVRF. The aim of this study was to analyze the possible role of Qalb as a predictor of conversion to dementia in patients with mild cognitive impairment (MCI). Method A total of 144 individuals with MCI were recruited from the BIODEGMAR cohort at Hospital del Mar (Barcelona) from 2017 to 2021. Study protocol included neuropsychological assessment, blood sampling, lumbar puncture and brain MRI. Follow‐up visits were performed yearly (12 +‐2 months) until January 2023. The endpoint of the study was a diagnosis of dementia (Global Deterioration Scale –GDS‐ &gt; 3 and/or Clinical Dementia Rating ‐CDR‐ score &gt; 0.5). BBBp was measured by CSF/serum albumin ratio (Qalb). Azheimer’s Disease (AD) was biologically‐defined according to CSF Aβ42/p‐tau ratio (AD+/‐). A composite vascular score (CVS) was calculated by assigning one point for the presence of each of the following CVRF (hypertension, hyperlipidemia and diabetes mellitus) plus another point if Fazekas scale higher than 1 or presence of brain infarcts on MRI. We performed a multivariate Cox regression analysis including the following variables: age, sex, AD and CVS. Result Sixty‐two cases (39.2%) developed dementia in a median follow‐up of 25.89 +/‐ 13.98 months. Univariate analysis showed that Qalb (p &lt; 0.01), AD+ (p &lt; 0.01) and CVS (p = 0.016) were associated with dementia. The regression model results showed an independent relationship between conversion to dementia and Qalb, HR = 1.333 (95% CI 1.185‐1.499) and AD+, HR = 4.118 (2.202‐7.699). Conclusion An increase in BBBp was independently associated with a higher risk of conversion to dementia in MCI patients. This result points to a potential role of Qalb as a useful biomarker of clinical prognosis of MCI patients.</abstract><doi>10.1002/alz.077089</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record>
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title Blood‐brain barrier permeability and risk of conversion to dementia in patients with mild cognitive impairment
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