Carotid artery atherosclerosis is correlated with cognitive impairment in an elderly urban Chinese non-stroke population

Abstract

Carotid artery atherosclerosis may cause increased intima-media thickness (IMT), plaque formation, and vessel stenosis or occlusion. However, the association between carotid artery atherosclerosis and cognitive impairment remains uncertain. This study explored the effects of IMT and carotid artery stenosis on cognitive function in an elderly Chinese non-stroke population. A total of 2015 patients were recruited. The IMT of carotid arteries and the presence of plaques and stenosis in carotid arteries were assessed with B-mode ultrasound examination. Cognitive performance was evaluated with neuropsychological tests. The cross-sectional relationships between cognitive performance and carotid wall characteristics were analyzed. Carotid artery atherosclerosis (IMT>1.0) and stenosis were found in 86% and 51% of patients, respectively. Cognitive impairment was found in 356 (17.7%) patients. After adjustment for possible confounders, IMT (odds ratio [OR]=1.96; 95% confidence interval [CI] 1.23–3.16) and hyperdense plaque (OR=4.72; 95% CI 2.56–11.2) were associated with poor cognitive performance. Patients with severe (⩾70%) carotid artery stenosis had a lower Mini-Mental State Examination score compared with the mild to modest (40–70%) carotid artery stenosis group. Cognitive performance differed between patients with left and right carotid artery stenosis, but no differences were observed between patients with severe left and right carotid artery stenosis. This study indicates that carotid artery atherosclerosis is correlated with cognitive impairment in the elderly Chinese population. A larger sample size across multiple centers and a longitudinal study are required to further explore the impact of carotid artery atherosclerosis on cognition in the elderly population.