Journal article
Cognitive decline in Dutch-type hereditary and sporadic cerebral amyloid angiopathy: a 5-year follow-up study
Alzheimer's & dementia, Vol.22(7), e71629
2026
PMID: 42360287
Abstract
Introduction
Cerebral amyloid angiopathy (CAA) is associated with cognitive impairment, but its longitudinal course of cognitive decline remains unclear. We investigated domain-specific cognitive trajectories in Dutch-type hereditary (D-CAA) and sporadic CAA (sCAA) to compare patterns and rates of decline.
Methods
We included 181 participants – 93 D-CAA mutation carriers (59 without, 34 with prior intracerebral hemorrhage [ICH]) and 88 with sCAA (57 without, 31 with ICH) – who underwent annual neuropsychological assessment. Longitudinal change in global cognition, memory, processing speed, and executive function was analyzed using linear mixed models.
Results
Over 5 years, cognitive decline was subtle but measurable. Memory and processing speed declined in D-CAA with prior ICH, whereas D-CAA without ICH and sCAA remained relatively stable. Global cognition showed a modest but significant decline, while executive function remained stable.
Discussion
CAA-related cognitive decline appears domain- and stage-dependent, suggesting progressive small-vessel injury rather than acute hemorrhage may drive deterioration.
Highlights
∙ Cognitive decline in CAA is subtle but measurable over time, showing domain- and stage-specific patterns rather than overall deterioration.
∙ D-CAA mutation carriers with a history of ICH showed a decline in memory and processing speed, whereas cognitive function remained relatively stable in D-CAA mutation carriers without ICH and in patients with sCAA.
∙ Executive dysfunction was present at baseline across all CAA groups and remained stable over 5 years, suggesting a stable, early-onset deficit possibly related to small-vessel pathology.
Details
- Title
- Cognitive decline in Dutch-type hereditary and sporadic cerebral amyloid angiopathy: a 5-year follow-up study
- Authors/Creators
- Rosemarie van Dort - Leiden University Medical CenterVera C J van Stek-Smits - Leiden University Medical CenterSanne E Schriemer - Leiden University Medical CenterReinier G J van der Zwet - Leiden University Medical CenterManon R Schipper - Leiden University Medical CenterSabine Voigt - Leiden University Medical CenterEllen P Hart - Leiden University Medical CenterVandhana Easwaran - Murdoch UniversityHamid R Sohrabi - Murdoch UniversityKevin Taddei - Edith Cowan UniversitySamantha L Gardener - Edith Cowan UniversityRalph N Martins - Edith Cowan UniversitySteven M Greenberg - Harvard UniversityMatthias J P van Osch - Leiden University Medical CenterMarianne A A van Walderveen - Leiden University Medical CenterMarieke J H Wermer - Leiden University Medical CenterEllis S van Etten - Leiden University Medical Center
- Publication Details
- Alzheimer's & dementia, Vol.22(7), e71629
- Publisher
- Wiley Periodicals LLC on behalf of Alzheimer's Association
- Number of pages
- 13
- Grant note
- 2016T086 / Dutch Heart Foundation TRACK D-CAA consortium
- Identifiers
- 991005896971407891
- Copyright
- © 2026 The Author(s).
- Murdoch Affiliation
- School of Psychology; Centre for Healthy Ageing; Health Futures Institute
- Language
- English
- Resource Type
- Journal article
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