Introduction Although historically considered two distinct entities, both vascular dementia (VD) and Alzheimer's Dementia (AD) are associated with increased odds of cerebrovascular disease. While early-onset AD ( To address the findings that peripheral artery disease (PAD) and AS play a key role in the development of both VD and AD, we plan to determine the relationship between BACs and dementia. We hypothesize that women with dementia have more severe BACs than healthy controls. Methods This is a multisite (UCLA Health, West Los Angeles VA Medical Center) study involving review of electronic medical records (EMRs) at these two affiliated institutions. Our primary objectives are to (1) evaluate whether higher degrees of BACs correlate with clinical diagnosis of dementia, and (2) validate screening mammograms as biomarkers for identifications of women at risk of dementia. Secondary objectives are to (1) evaluate whether higher degrees of BACs correlate with greater WMD on brain MRIs, and (2) identify contributing metabolic factors to BACs as potential targets for prevention of AS and therefore dementia. We will extract data from EMRs of post-menopausal women 50 years and older with a diagnosis of dementia over the past 10 years and sex/age-matched controls without dementia. All women will have undergone mammogram within two years of dementia diagnosis. We anticipate approximately 800 subjects. The following characteristics will be analyzed as co-variates/confounding factors: chronic kidney disease, diabetes, osteoporosis, hormone replacement treatment, vitamin D level, estrogen level, BMI as well as h/o smoking, stroke and/or TIA, depression, and head trauma. For imaging analysis, degree of BACs will be scored using a four-point scale, considering severity and extent of calcifications (see Figure). For women with brain MRI scans available within one year of the mammogram study date, degree of WMD will also be scored on a four-point scale according to the Fazekas (AJR. 1987;149:351-6) score. For statistical analysis, we will first compare women with dementia and controls on demographics to ensure that they are well-matched, or identify variables to use as covariates in the analyses. Calcification burden will be compared between these subject groups using t-tests or ANCOVAs (if covariates are needed). For women with MRI scans, we will use chi-squared or Fisher's exact tests to test for associations between calcification burden and WMD. Results This study recently received IRB approval from one of the two participating sites and is pending IRB review from the second site. Preliminary data are estimated to be available for presentation at the time of the 2018 Annual Meeting. Conclusions Previous reports indicate that the prevalence of mammographically-detected BACs can be as high as 29%. In clinical practice, however, BACs are not consistently reported because are considered “incidental findings” having no relation to breast malignancy. A 2014 meta-analysis demonstrated a strong association between BACs and cardiovascular disease. In a recent 2018 autoptic study (Overisgaran et al. Acta Neuropathol. 2018 Oct 17. doi: 10.1007/s00401-018-1920-1) including postmortem data from 1453 individuals concluded that women had higher levels of AD pathology as well as more severe arteriolosclerosis. While there are other more invasive methods to assess AS, mammograms can provide a simple and readily available and provide longitudinal “snap-shots” of PAD in asymptomatic women and may help elucidate the relationship between medial artery sclerosis as a separate entity in increasing risk for cognitive impairment. This research was funded by UCLA Health, U.S. Department of Veterans Affairs, Semel Institute for Neuroscience & Human Behavior