biostudies-literatureUnknown6(6)Godrich DCerebral amyloid angiopathy commonly co-occurs with amyloid β plaques and neurofibrillary degeneration and is proposed to contribute to cognitive impairment. However, the interplay among these pathologic changes of Alzheimer disease is not well understood. Here we replicate and extend findings of a recent study that suggested the association of cerebral amyloid angiopathy and cognitive impairment is mediated by neurofibrillary degeneration. We employed similar approaches but in a larger, clinical-based (as opposed to community-based) set of 4915 autopsied National Alzheimer's Coordinating Center participants (60% with dementia). Neuropathologic lesions were measured ordinally; longitudinal change in cognition was used to measure cognitive impairment. Statistical analyses included ordinal lBrain communicationsfcae369https://www.ebi.ac.uk/biostudies/studies/S-EPMC11581998biostudies-literatureCerebral amyloid angiopathy impacts neurofibrillary tangle burden and cognition.PMC11581998Kukull WSchellenberg GVance JMMartin ERForoud TRundek TPericak-Vance MACuccaro MLBeecham GWGodrich DScott WKMontine TJPasteris JfalseCerebral amyloid angiopathy impacts neurofibrillary tangle burden and cognition.Cerebral amyloid angiopathy commonly co-occurs with amyloid β plaques and neurofibrillary degeneration and is proposed to contribute to cognitive impairment. However, the interplay among these pathologic changes of Alzheimer disease is not well understood. Here we replicate and extend findings of a recent study that suggested the association of cerebral amyloid angiopathy and cognitive impairment is mediated by neurofibrillary degeneration. We employed similar approaches but in a larger, clinical-based (as opposed to community-based) set of 4915 autopsied National Alzheimer's Coordinating Center participants (60% with dementia). Neuropathologic lesions were measured ordinally; longitudinal change in cognition was used to measure cognitive impairment. Statistical analyses included ordinal l2024-01-01T00:00:00Z20242025-04-04T08:31:30.118Z2025-04-04T08:31:30.118ZS-EPMC115819983958415610.1093/braincomms/fcae369