From cognition to daily functioning: Insights from iatrogenic cerebral amyloid angiopathy

INTRODUCTION: Iatrogenic cerebral amyloid angiopathy (iCAA) is a rare form of cerebral amyloid angiopathy (CAA) caused by exposure to cadaveric dura mater grafts. Cognitive and health-related quality of life (HRQoL) outcomes in iCAA remain poorly characterized. This study explored cognitive performance and HRQoL and their associations with clinical and psychosocial factors. METHODS: In a cross-sectional study (2021-2025) at Fondazione IRCCS Istituto Neurologico Carlo Besta, probable iCAA was identified among 412 CAA patients. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and Frontal Assessment Battery (FAB), HRQoL with Short Form-36 (SF-36) questionnaire. RESULTS: Twenty patients were included (40%female). Global cognition was preserved. Executive functions were associated with HRQoL general health and physical functioning. Haemorrhagic onset or recurrences were related to lower MoCA scores. Social engagement was linked to better cognitive performance and perceived health. DISCUSSION: Subtle executive dysfunction was associated with HRQoL in cognitively preserved iCAA patients, supporting the relevance of cognitive and psychosocial assessment in clinical management.