It can be difficult to determine whether cognitive decline in older people is due to vascular problems or dementia. A new study identifies biomarkers associated with vascular causes of cognitive impairment that may help distinguish between the two.
Cerebrovascular disease causes progressive damage to the cells lining the small blood vessels in the brain and is known to be a significant cause of cognitive impairment and dementia. The cerebrovascular damage seen in vascular disease is similar to that seen in Alzheimer’s disease, making it difficult to pinpoint the cause.
Physicians rely on magnetic resonance imaging (MRI) and computed tomography (CAT) scans to distinguish between vascular damage and Alzheimer’s disease, but with some guesswork. But new research has identified diagnostic biomarkers that may take some of the guesswork out of it.
The research, led by the University of California, Los Angeles (UCLA), focuses on the body’s formation of new blood vessels from pre-existing blood vessels, a process called angiogenesis. Angiogenesis involves signaling networks between and within endothelial cells, the predominant cell types found in the lining of blood vessels.
Researchers theorized that the body was trying to repair the damaged small blood vessels in the brain by promoting angiogenesis. We focused on placental growth factor (PlGF), a key molecule in the process.
As part of the study, 335 participants underwent MRI brain imaging and cognitive testing. Blood samples were taken including measurement of PlGF levels.
Results showed that participants with cognitive deficits and brain imaging consistent with cerebrovascular disease also had elevated plasma levels of PlGF. People in the top quartile of PlGF levels (more than 75% of those tested) were three times as likely to have cognitive impairment or dementia than those in the bottom quartile.
Identifying PlGF as a biomarker that vascular disease contributes to cognitive decline is an important step to distinguish this type of cognitive impairment from that caused by Alzheimer’s disease.
“By adding blood-based biomarkers that are relevant to conventional measures of vascular injury, [healthcare] “To help health care providers distinguish between patients with predominance of Alzheimer’s dementia and those with significant vascular contributions,” said Jason Hinman, M.D., Ph.D., lead author of the study. “Right now, that’s the clinician’s best guess. This study can directly inform this diagnostic decision.”
This research Alzheimer’s Disease and Dementia: Journal of Alzheimer’s Disease.
Source: UCLA via EurekAlert!
