Biomarkers for Vascular Contributions to Cognitive Impairment and Dementia Consortium

Open to people ages 60-90

• Age ≥ 60 and ≤ 90 years
• Diagnosis of normal cognition with at least one criterion for vascular risk*, subjective cognitive decline (preliminary diagnosis based on self-report question or eCog-12), mild cognitive impairment, or mild dementia based on standard research criteria
• Fluent in English or Spanish
• No contraindications to MRI including CVR

• No confounding neurologic, psychiatric, or medical disease

  *Participants with normal cognition must meet at least one criterion (diabetes, OR hypertension plus, OR MRI factors) for vascular risk prior to enrollment:

• Diabetes (at least one of the following):
  • Fasting (8-hour fast, usually overnight) blood sugar ≥126 mg/dL (≥7 mmol/L, or ≥1260 mg/L)
  • Random or Post-prandial blood sugar ≥200 mg/dL (≥11.11 mmol/L, or ≥2000 mg/L)
  • HbA1C ≥6.5% (or ≥47.5412 mmol/mol)
  • Treatment with an anti-diabetic medicine
• Hypertension plus (at least two of the following):
  • Use of anti-hypertensive medications for lowering blood pressure for ≥ 10 years
  • Current use of two or more anti-hypertensive medications for lowering blood pressure
  • One measured blood pressure in a research or clinical setting in the last 2 years with SBP ≥140 or DBP ≥90
  • A second measured blood pressure in a research or clinical setting on a different date in the last 2 years with SBP ≥140 or DBP ≥90
  • Evidence of likely HTN end-organ damage (e.g., LVH, albuminuria, eGFR<60, CHF)
• MRI factors (at least one of the following):
  • Peri-Ventricular Fazekas Extent Grade or Deep Fazekas Extent Grade ≥ 2
  • 1 or more microbleeds
  • 1 or more lacunar infarcts

• Neurologic Disease: Based on the available data and investigator's impression, exclude those with confounding neurologic disease that would interfere with test performance or with biomarker analysis:
  • Frontotemporal lobar degeneration (FTLD)
  • Lewy body dementia (LBD)
  • Parkinson's disease
  • Multi system atrophy
  • Traumatic brain injury (TBI)-related cognitive impairment
  • TBI that interferes with MRI biomarker analyses (e.g., large volume traumatic lesion)
  • Non-small vessel strokes that interfere with test performance (e.g., post-stroke cognitive impairment or aphasia)
  • Non-small vessel strokes that interfere with MRI biomarker analysis (e.g., large volume strokes)
  • CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy)
  • Individuals known to be receiving, or planning to receive, anti-amyloid immunotherapy*
  • Other neurologic conditions that interfere with test performance or biomarker analysis
    • Individuals prescribed anti-amyloid immunotherapy after MarkVCID enrollment should be kept in the study.
• Medical and Psychiatric Conditions: Exclude those with medical and psychiatric conditions that would confound the course or interfere with test performance:
  • Schizophrenia or other active/severe psychotic disorders
  • Medical or psychiatric conditions likely to interfere with participation or retention (e.g., metastatic or malignant CNS cancer, active/severe depression or anxiety, HIV- Associated Neurocognitive Disorder)
  • Contraindications to MRI procedures, such as:
    • Claustrophobia
    • Cardiac pacemaker
    • Intracranial clips/metal implants
  • Contraindications to CVR:
    • COPD or other respiratory condition requiring oxygen therapy
    • Asthma or other respiratory condition requiring current use of medications such as inhalers