On the prevalence of cerebral amyloid angiopathy a systematic review and meta-analysis

Lieke Jäkel and Anna de Kort, both PhD students with Marcel Verbeek, and neurologists Floris Schreuder and Karin Klijn performed a systematic review and meta-analysis on the prevalence of Cerebral Amyloid Angiopathy (CAA) in several populations. The study is published in Alzheimers and Dementia, on May 31st 2021.

For the current study, 170 publications were scrutinized and analyzed, comprising publications using either a neuroimaging or a neuropathological approach. CAA is associated with cognitive dysfunction and intracerebral hemorrhage, and linked to immunotherapy-related side-effects in Alzheimer’s disease (AD). Given ongoing efforts to develop AD immunotherapy, accurate estimates of CAA prevalence are important. In this review, it is concluded that prevalence is high in AD (48%) and substantial in the general population (23%) when neuropathological examination is possible.  In contrast, however, CAA could only be demonstrated in one third (population) to one half (AD patients) of the subjects when neuroimaging was applied.

This study demonstrates that the prevalence of CAA in the general population and AD is significant, but that current diagnostic techniques fall short in its identification, calling for more sensitive biomarkers for CAA. This is particularly relevant with the very recent conditional approval of anti-amyloid antibody aducanumab for treatment of AD, the side-effects of which are strongly associated with CAA.

Publication

Lieke Jäkel, Anna M. De Kort, Catharina J.M. Klijn, Floris H.B.M. Schreuder, Marcel M. Verbeek. Prevalence of cerebral amyloid angiopathy: A systematic review and meta-analysis (2021), Alzheimer’s and Dementia.