Intima Media Thickness and Cognitive Function Among Adults: Meta‐Analysis of Observational and Longitudinal Studies

Abstract

Background Carotid structural changes measured by intima media thickness (IMT) have been related to cognitive complaints during aging. Therefore, the aims of this meta‐analysis were (1) to elucidate the relationship between vascular status, measured as IMT, and cognitive domains distinguishing between global cognition, executive functions, memory and attention; and (2) to explore whether demographic (ie, age and sex), clinical (ie, body mass index and IMT baseline values), and procedure characteristics influence this association. Methods and Results We performed a systematic review of MEDLINE (via PubMed), Scopus, and Web of Science databases from their inception to June 2021. Studies meeting the following inclusion criteria were included: (1) the participants were adults; (2) the exposure was carotid IMT; (3) the outcome was cognitive function, including global cognition, executive function, memory, and attention measured using standardized tests; and (4) the study design was cross‐sectional or longitudinal including unadjusted and adjusted analyses. A total of 19 cross‐sectional and 15 longitudinal studies were included and demographic (age and sex), clinical (body mass index and baseline IMT values), and procedure characteristics were analyzed as potential mediator or moderators of the association. Conclusions Our data support negative associations between IMT and cognitive function in cross‐sectional studies. The association between IMT and cognition lost significance in longitudinal studies and when controlling for covariates in cross‐sectional studies. Finally, the strength of these associations seems not to be modified by age, sex, body mass index, and baseline IMT values. This systematic review and meta‐analysis adds to the evidence supporting the use of IMT as a measure for identifying patients at risk of cognitive decline.

Peran Ketebalan Tunika Intima Media Karotis Terhadap Fungsi Kognitif Pada Wanita Menopause

“…Hal ini mengindikasikan bahwa fungsi kognitif berkurang pada orang dengan penebalan CIMT. [32] Penelitian yang dilakukan oleh Frazier, dkk menunjukkan peningkatan nilai CIMT, yang merupakan penanda keadaan aterosklerosis, mengakibatkan penurunan fungsi kognitif bukan memori pada kelompok lanjut usia. [33] Penelitian lain melaporkan bahwa penebalan CIMT dan Flow-Mediated Dilation (FMD) berkaitan dengan fungsi neurokognitif yang lebih buruk pada keadaan obesitas dengan tekanan darah tinggi.…”

“…[33] Penelitian lain melaporkan bahwa penebalan CIMT dan Flow-Mediated Dilation (FMD) berkaitan dengan fungsi neurokognitif yang lebih buruk pada keadaan obesitas dengan tekanan darah tinggi. [32] Didapatkan pula hubungan yang kuat antara peningkatan CIMT dengan fungsi kognitif yang buruk di dalam populasi peminum alkohol. [34] Pemeriksaan fungsi kognitif menggunakan Mini-Mental State Examination (MMSE) yang dihubungkan dengan CIMT pada penelitian menggunakan analisis regresi linier multivariat didapatkan hubungan yang kuat antara CIMT dan fungsi kognitif pada kelompok dewasa muda dan lanjut usia di Republik Rakyat Tingkok.…”

“…[35] Selain itu, pada penelitian kohort yang dilakukan pada tahun 2005-2008, memperlihatkan adanya hubungan yang signifikan antara IMT dengan fungsi kognitif pada interval usia 21 -84 tahun. [32] Penelitian kohort selama 12 tahun pada kelompok wanita usia 70 -80 tahun, menunjukkan CIMT merupakan alat ukur yang berguna untuk mengidentifikasi memprediksi peningkatan resiko MCI sebelum muncul gejala demensia pada wanita lansia. [36] Insiden MCI adalah 4,5% pada 6376 wanita pascamenopause yang dievaluasi selama 5,4 tahun dalam Women's Health Initiative Memory Study (WHIMS).…”

Associations of arterial thickness, stiffness and blood pressure with brain morphology in early adolescence: A prospective population-based study

“…While cardiovascular disease remains the leading cause of death worldwide, the global burden of brain disease is rapidly increasing and is often associated with the same risk factors, as highlighted by the latest statistical update from the American Heart Association 1 . Indeed, known cardiovascular risk factors such as hypertension [2][3][4] , arterial stiffness [5][6][7] and atherosclerosis [8][9][10] , have been consistently associated with the pathogenesis of cerebrovascular disease (e.g., stroke and white matter lesions) and cognitive decline in the elderly.…”

Risk factors and a prediction model for unruptured intracranial aneurysms in patients with ischemic stroke using carotid intima-media thickness and systemic atherosclerosis

“…The thickening of the arterial wall can be observed before the narrowing of the lumen and symptoms of the disease ( 10 ). Studies have previously demonstrated that carotid IMT is significantly associated with carotid plaque development, cardiovascular risk, and cognitive function ( 11 – 13 ). Moreover, a previous study found that the incidence of intracranial aneurysms in patients with IS was 6.6%, and the risk factors included female sex and old age ( 14 ).…”