Cardiovascular risk factors and vascular neuropathological findings in primary age-related tauopathy versus Alzheimer's disease.

Cardiovascular risk factors (CVRFs) are prevalent and modifiable contributors to dementia risk; however, their contributions to vascular pathologies across dementia etiologies has not been examined extensively. This study assessed differences in the prevalence of CVRFs and vascular neuropathologies between people with primary age-related tauopathy (PART) and Alzheimer's disease neuropathology (ADNP), and whether CVRFs associated differentially with vascular co-neuropathologies and antemortem cognitive status between groups. 5144 individuals from the National Alzheimer's Coordinating Center with PART or ADNP were included. The prevalence of CVRFs (hypertension, diabetes, obesity, hypercholesterolemia), and vascular pathologies (cerebral amyloid angiopathy [CAA], cerebrovascular neuropathology [CVNP], arteriolosclerosis, and atherosclerosis) were compared between participants with PART and ADNP. Associations between CVRFs and vascular pathologies were compared between PART and ADNP. Associations between vascular pathologies and Mini Mental Status Examination (MMSE) scores at last visit were compared between PART and ADNP. Diabetes and obesity were more prevalent in individuals with PART compared to ADNP. Individuals with PART had lower prevalence of CAA, arteriolosclerosis, and atherosclerosis. Associations between CVRFs and vascular pathologies differed between PART and ADNP; in PART, diabetes associated with CVNP and obesity associated with arteriolosclerosis, while in ADNP, hypercholesterolemia more strongly associated with CVNP. ADNP associated with lower MMSE scores versus PART. In PART, arteriolosclerosis associated with lower MMSE scores, while in ADNP, CAA and atherosclerosis associated with lower MMSE scores. These findings highlight differences in neuropathological manifestations of CVRFs, and their relationships with antemortem cognitive status, in the presence of PART vs. AD neurodegenerative pathology.