Cognitive characteristics of non-hemorrhagic cerebral amyloid angiopathy--Data from PUMCH dementia cohort

doi:10.11817/j.issn.1673-9248.2024.04.001

Abstract

Abstract:

Objective

To explore the cognitive characteristics of non-hemorrhagic cerebral amyloid angiopathy (CAA) patients with cognitive impairment, in order to guide clinical cognitive training.

Methods

All the participants were from the dementia cohort of Peking Union Medical College Hospital (PUMCH) between 2007 and 2023. They all underwent history inquiry, brain MRI, cognitive evaluation, blood biochemical test, gene sequencing, and met the diagnostic criteria for probable CAA. None of them had a history of symptomatic intracranial hemorrhage. Cognitive evaluation included the mini-mental state exam (MMSE), activities of daily life, as well as cognitive domain assessments (including visuospatial, memory, executive, reasoning and linguistic domains). According to the MMSE scores, the subjects were divided into two subgroups: one with MMSE scores greater than 20, and another with MMSE scores between 10 and 20, inclusive. Analysis of variance was used to compare the three immediate memory items of auditory verbal learning test (AVLT) between the two groups.

Results

A total of 34 patients with CAA were enrolled, including 12 males and 22 females with a mean age of (74.0±7.1) years. Memory and executive disorders were the most prominent, occurring in 97.1% (33/34) and 73.5% (25/34) subjects. Linguistic, visuospatial, and reasoning dysfunctions were observed in 38.2% (13/34), 35.3% (12/34), and 5.9% (2/34) of subjects, respectively. Among the MMSE>20 (n=20) and 10<MMSE≤20 (n=14) subgroups, AVLT1, AVLT2, and AVLT3 demonstrated a significantly increasing trend [(2.40±1.10) vs (4.10±1.92) vs (4.90±2.00), F=11.034, P <0.001; (1.64±0.84) vs (2.21±1.48) vs (3.36±1.95), F=4.793, P=0.017].

Conclusion

The non-hemorrhagic CAA patients are mainly characterized by memory and executive dysfunction. Those with mild-to-moderate cognitive impairment, as indicated by MMSE scores greater than 10, have relatively preserved reasoning and learning abilities. In clinical practice, we can leverage these reserved cognitive abilities to provide them cognitive training, with the aim of delaying their cognitive decline.

Key words: Cerebral amyloid angiopathy, Cognition, Memory, Executive function

Liling Dong, Tianyi Wang, Chenhui Mao, Yuhan Jiang, Li Shang, Jialu Bao, Yuyue Qiu, Shanshan Chu, Wei Jin, Jun Ni, Jing Gao. Cognitive characteristics of non-hemorrhagic cerebral amyloid angiopathy--Data from PUMCH dementia cohort[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2024, 18(04): 295-300.

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认知域	整体（n=34）	MMSE>20分组（n=20）	MMSE≤20分组（n=14）	统计值	P值
临摹^#（）	-1.11±2.24	-0.47±1.33	-2.03±2.93	t=1.864	0.080
积木^#（）	-5.39±3.01	-4.49±3.20	-6.68±2.24	t=2.206	0.035
Rey图形临摹^#（）	-0.72±2.30	-0.71±2.44	-0.73±2.18	t=0.018	0.985
Rey图形回忆^#（）	-3.35±2.42	-2.52±2.34	-4.53±2.08	t=2.579	0.015
AVLT-I^#（）	-1.57±1.02	-1.19±1.00	-2.10±0.83	t=2.790	0.009
AVLT4^#（）	-2.29±1.06	-2.05±1.25	-2.64±0.58	t=1.656	0.107
AVLT5^#（）	-2.05±0.97	-1.89±1.18	-2.28±0.50	t=1.157	0.256
AVLT-T^#（）	-2.03±1.02	-1.72±1.13	-2.48±0.64	t=2.251	0.031
AVLT6（分，）	1.09±1.99	1.70±2.40	0.21±0.43	t=2.699	0.014
AVLT7（分，）	15.26±6.02	16.20±5.85	13.93±6.22	t=1.086	0.285
情景记忆^#（）	-1.79±0.73	-1.51±0.78	-2.20±0.42	t=3.361	0.002
联想学习^#（）	-2.57±0.53	-2.47±0.53	-2.72±0.52	t=1.398	0.172
列名^#（）	-0.83±1.00	-0.48±0.89	-1.33±0.96	t=2.685	0.011
数字符号^#（）	-0.11±0.69	0.05±0.67	-0.35±0.67	t=1.744	0.091
连线测验A^#（）	-4.29±4.14	-2.97±2.48	-6.19±5.27	t=2.131	0.048
相似性^#（）	-0.23±0.76	-0.16±0.80	-0.34±0.71	t=0.682	0.500
计算^#（）	-1.41±0.87	-1.19±0.95	-1.73±0.65	t=1.822	0.078
非流利语言[例（%）]	0（0）	0（0）	0（0）	-	-
复述障碍[例（%）]	16（47.1）	9（45.0）	7（50.0）	χ²=0.083	1.000
命名障碍[例（%）]	6（17.6）	1（5.0）	5（35.7）	χ²=5.346	0.061
听指令执行障碍[例（%）]	14（41.2）	6（30.0）	8（57.1）	χ²=2.505	0.163
颜色命名障碍[例（%）]	3（8.8）	0（0）	3（21.4）	χ²=4.700	0.061

认知域	整体（n=34）	MMSE>20分组（n=20）	MMSE≤20分组（n=14）	统计值	P值
临摹^#（）	-1.11±2.24	-0.47±1.33	-2.03±2.93	t=1.864	0.080
积木^#（）	-5.39±3.01	-4.49±3.20	-6.68±2.24	t=2.206	0.035
Rey图形临摹^#（）	-0.72±2.30	-0.71±2.44	-0.73±2.18	t=0.018	0.985
Rey图形回忆^#（）	-3.35±2.42	-2.52±2.34	-4.53±2.08	t=2.579	0.015
AVLT-I^#（）	-1.57±1.02	-1.19±1.00	-2.10±0.83	t=2.790	0.009
AVLT4^#（）	-2.29±1.06	-2.05±1.25	-2.64±0.58	t=1.656	0.107
AVLT5^#（）	-2.05±0.97	-1.89±1.18	-2.28±0.50	t=1.157	0.256
AVLT-T^#（）	-2.03±1.02	-1.72±1.13	-2.48±0.64	t=2.251	0.031
AVLT6（分，）	1.09±1.99	1.70±2.40	0.21±0.43	t=2.699	0.014
AVLT7（分，）	15.26±6.02	16.20±5.85	13.93±6.22	t=1.086	0.285
情景记忆^#（）	-1.79±0.73	-1.51±0.78	-2.20±0.42	t=3.361	0.002
联想学习^#（）	-2.57±0.53	-2.47±0.53	-2.72±0.52	t=1.398	0.172
列名^#（）	-0.83±1.00	-0.48±0.89	-1.33±0.96	t=2.685	0.011
数字符号^#（）	-0.11±0.69	0.05±0.67	-0.35±0.67	t=1.744	0.091
连线测验A^#（）	-4.29±4.14	-2.97±2.48	-6.19±5.27	t=2.131	0.048
相似性^#（）	-0.23±0.76	-0.16±0.80	-0.34±0.71	t=0.682	0.500
计算^#（）	-1.41±0.87	-1.19±0.95	-1.73±0.65	t=1.822	0.078
非流利语言[例（%）]	0（0）	0（0）	0（0）	-	-
复述障碍[例（%）]	16（47.1）	9（45.0）	7（50.0）	χ²=0.083	1.000
命名障碍[例（%）]	6（17.6）	1（5.0）	5（35.7）	χ²=5.346	0.061
听指令执行障碍[例（%）]	14（41.2）	6（30.0）	8（57.1）	χ²=2.505	0.163
颜色命名障碍[例（%）]	3（8.8）	0（0）	3（21.4）	χ²=4.700	0.061

组别	例数	视空间障碍	记忆障碍	执行障碍	推理计算障碍	语言障碍
MMSE>20分组	20	4（20.0）	19（95.0）	13（65.0）	2（10.0）	5（25.0）
MMSE≤20分组	14	8（57.1）	14（100）	12（85.7）	0（0）	8（57.1）
χ²值		4.975	0.721	1.815	1.488	3.603
P值		0.036	1.000	0.250	0.501	0.080

组别	例数	视空间障碍	记忆障碍	执行障碍	推理计算障碍	语言障碍
MMSE>20分组	20	4（20.0）	19（95.0）	13（65.0）	2（10.0）	5（25.0）
MMSE≤20分组	14	8（57.1）	14（100）	12（85.7）	0（0）	8（57.1）
χ²值		4.975	0.721	1.815	1.488	3.603
P值		0.036	1.000	0.250	0.501	0.080

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