ArticleAlzheimer's & dementia : the journal of the Alzheimer's Association2026
Modeling small vessel disease burden and vascular dementia likelihood from NACC data.
Article in Alzheimer's & dementia : the journal of the Alzheimer's Association, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionCerebrovascular pathology contributes to dementia but lacks standardized quantification for multicenter datasets. We developed harmonized indices to quantify small vessel disease (SVD) and vascular cognitive impairment (VCI) likelihood using National Alzheimer's Coordinating Center Neuropathology 11 data.
methodsSix cerebrovascular domains were scored (0 to 3) and aggregated into a SVD index (0 to 18), with proportional scaling when ≥5 domains were available. A vascular cognitive impairment neuropathology guideline (VCING)-Lite proxy substituted global for occipital-specific ratings. A principal component analysis-derived global-cognition factor and clinical dementia status were modeled against vascular indices. Coherence was tested across complete, domain-complete, and Alzheimer's disease neuropathologic change (ADNC)-limited subsets.
resultsSVD scores were consistent across datasets, with lower values only in the ADNC-limited subset (p < 0.003). SVD-VCING-Lite correlations remained strong after adjustment (r = 0.72, p < 0.001). Both were associated with worse global cognition and higher odds of dementia. DISCUSSION: This framework links cerebrovascular pathology to in-life outcomes and enables reproducible modeling of vascular contributions in mixed dementias.
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