Project: Realising the potential of cohort studies to determine the vascular contribution to neurodegeneration
Neurodegeneration is a multifactorial process to which vascular disease, notably intrinsic cerebral small vessel disease (SVD) both adds pathology and may accelerate the neurodegenerative process. However
the vascular contribution to neurodegeneration has been largely overlooked: 45% of all dementias are due wholly or in part due to vascular disease, yet most attention is directed to Alzheimer’s disease (AD).
Research on the effects of SVD on neurodegeneration is hampered by scant, imprecise data on long term event rates, risk factors, variation in vascular contributions between populations, and consequently by lack
of targets for intervention. Substantial information to advance the field is available in individual cohorts, including several listed in the recent JPND report. Although individually these are relatively small, represent
specific populations and have modest long term data, if combined, they could provide large statistically robust and generalisable data samples and a platform for future clinical trials and mechanistic research.
The applicants have already demonstrated their ability to work together very effectively through the COENfunded project on Imaging standards for determining the vascular contribution to neurodegeneration (2012-
13).1 In the present proposal, a logical sequelae to the COEN project, we will create a central catalogue of cohort studies relevant to vascular contributions to neurodegeneration as a first step to establishing a core
shared database of tabular, imaging and other data. A cohort library and shared database will: facilitate assessment of presymptomatic disease, imaging, clinical, cognitive and laboratory biomarkers; identify
outcomes for future cohorts and clinical trials that are sensitive to vascular effects; test the feasibility of combining imaging data from different cohorts so as to harmonise image and data processing; determine
feasibility of data linkage in contributing countries and of establishing clinical trials of interventions for SVD in subjects recruited into existing or ongoing cohorts. The applicants’ cohorts total some 14,000 subjects,
integrated with national initiatives in UK (Dementia Platform), Germany (DZNE) and the Netherlands.
There is substantial enthusiasm for this endeavour from experts from the COEN initiative and others with relevant cohort data keen to see the potential value maximised.
Project partner
