Association of small vessel disease progression with longitudinal cognitive decline across mild cognitive impairment

Background Cerebral small vessel disease (SVD) is the leading cause of vascular dementia. However, it is unclear whether the individual SVD or global SVD progression correlates with cognitive decline across mild cognitive impairment (MCI) subjects. Objective To investigate the association of small vessel disease progression with longitudinal cognitive decline across MCI. Methods We included 432 participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database, with 151 participants in the cognitively normal (CN) group and 281 participants in the MCI group. We evaluated magnetic resonance imaging–based SVD markers in both CN and MCI groups and explored their associations with 12-and 24-month cognitive decline using linear mixing effect (LME) models. Results In the CN group, cerebral microbleed (CMB) progression was associated with the decline in language function (p < 0.05), and deep white matter hyperintensity (WMH) progression was associated with a decline in memory function (p < 0.05). In the MCI group, CMB progression was associated with a decline in memory function (p < 0.05) and lacunes progression was associated with executive function (p < 0.05), whereas the progression of global SVD score was not related to longitudinal cognitive function. Conclusions The progression of CMB and WMH had an impact on cognitive decline in both CN and MCI groups, and lacunes progression only had an association with cognitive decline in the MCI group. Our study suggested that individual SVD markers may have a higher predictive value in longitudinal cognition compared with global SVD burden.