Carotid atherosclerosis and cognitive function in midlife: The beaver dam offspring study

Abstract

Background Atherosclerosis may be associated with cognitive function; however the studies are few, especially among midlife adults. Methods Participants in the Beaver Dam Offspring Study who had cognitive test data and gradable carotid artery ultrasound scans were included (n=2794, mean age: 49 years). Atherosclerosis was measured by carotid intima-media thickness (IMT) and presence of plaque. Cognitive function was measured by the Trail Making Test (TMT), Grooved Pegboard Test (GPT) and Mini-Mental State Examination (MMSE). Generalized cognitive function was defined by a summary score calculated from the TMT and GPT. Linear regression was used to evaluate the associations between carotid atherosclerosis and cognitive function tests. Results Larger IMT was associated with lower GPT, MMSE and the summary score adjusting for multiple factors, the coefficients were: 13.8 seconds (p<0.0001), −0.6 (p=0.007), and 0.47 (p=0.01), respectively for 1 mm increase in IMT. Plaque scores were significantly associated with TMT-B, GPT, MMSE, and the summary score adjusting for age, sex and education. The associations remained statistically significant after further adjustments except for the association with TMT-B, which was attenuated and no longer significant. Conclusions Our results show significant associations between markers of carotid atherosclerosis and cognitive function in a cohort of persons aged 21 to 84 years. Longitudinal studies are needed to further examine these associations.

Cardiovascular Biomarkers and Carotid IMT Scores as Predictors of Cognitive Function

“…There are also two cross-sectional studies in middle-aged adults that support this database's findings that cognitive function is negatively associated with carotid IMT scores [30,31].…”

“…Carotid IMT scores have also been shown to be associated with cognitive decline in the elderly [11][12][13] as well as in middle-aged adults [30,31]. Yet this is the first study that we are aware of that aims to assess the relationship between cardiovascular risk factors, carotid IMT scores, and cognitive function in healthy middle-aged adults and is able to control for multiple cardiovascular risk factors including aerobic fitness, nutrient intake, and detailed anthropometric and laboratory analyses simultaneously.…”

Sex Differences in the Prevalence of and Risk Factors for Nonvascular Cognitive Function in Rural, Low-Income Elderly in Tianjin, China

“…For instance, the INVADE population-based prospective study from Germany indicated that an increased carotid IMT significantly affected the 6-Item Cognitive Impairment Test score after adjusting for other factors [44]. The Beaver Dam Offspring Study from the United States suggested that MMSE scores were affected independently by carotid IMT and the presence of plaque [45]. Inconsistent with the above conclusions, we did not find a relationship between carotid atherosclerosis and cognitive function in this study for either men or women, which may be due to the very thin carotid IMT (0.60 ± 0.10 mm for men and 0.58 ± 0.08 mm for women) observed in this population compared with that in the other study from China [46] and the higher frequency of carotid plaques in this population (47.1% for men and 35.4% for women) [47].…”

Arterial Wall Function is Associated with Cognitive Performance Primarily in Elderly with Type 2 Diabetes

“…Nevertheless, the heterogenic effect of vasculopathy on different organs, as demonstrated by the 10-year difference between the peak incidence of myocardial infarction and that of stroke [40, 41], suggests that cerebral vessels are affected at a later stage than coronary vessels and stresses the relevance of the relationship of peripheral extra-cranial vessels function with cognition. An additional limitation is lack of data on carotid artery stenosis, previously demonstrated to be associated with cognitive function, independently of intracranial vascular changes (e.g., silent MRI infarcts, white matter lesions) [39, 42–44], and lack of structural imaging of brain parenchyma and vasculature, precluding any conclusions about the relationship of peripheral AWF with these factors. The study included only male subjects, limiting the generalizability of the findings to women.…”