- In subcortical vascular dementia, amyloid burden, independently or interactively with small vessel disease, contributed to longitudinal cognitive decline, and amyloid deposition was the strongest poor prognostic factor.
- This longitudinal cohort study enrolled 61 patients with subcortical vascular dementia from 2 tertiary referral centers.
- Patients had baseline MRI and 11C-Pittsburgh compound B (PiB) PET (to detect amyloid) and annual neuropsychological testing for 3 years.
- Generalized estimation equations allowed controlling for age, sex, education, APOE4, and follow-up interval.
- PiB positivity predicted faster decline in attention, visuospatial, visual memory, and global cognition function.
- More white matter hyperintensities predicted faster cognitive decline in attention, visuospatial, visual recognition memory, and language function.
- Lacunes and microbleeds were not predictors.
- Only PiB positivity was associated with faster decline on global dementia rating.
- Findings might not apply to patients seen in other settings.
Why this matters
- PET amyloid burden predicts cognitive decline in subcortical vascular dementia better than MRI small vessel disease.