VEGF growth factors are signalling proteins involved in the growth and maintenance of both vascular and neural cells, and appear protective against cognitive impairment,59 particularly in the context of Alzheimer's disease.60 Notably, VEGF-A and VEGF-D were not associated with cognitive functioning in this study, but VEGF-C was markedly higher in participants with unimpaired cognitive performance (according to both cognitive outcomes). Here, VEGFD is linked to early-onset autosomal dominant Alzheimer disease.