Risk factors for cognitive impairment in patients with asymptomatic carotid stenosis

Abstract

Objective To investigate the risk factors for cognitive impairment in patients with asymptomatic carotid stenosis (ACS). Methods Patients with ACS were enrolled. The related clinical data were collected, including age, gender, blood pressure, blood lipid, glycosylated hemoglobin, homocysteine (Hcy), white matter lesion (WML) and the degree of carotid stenosis. Montreal cognitive assessment (MoCA) was used to evaluate cognitive function. The patients were divided into either a cognitive impairment group (<26) or non-cognitive impairment group (≥26). Multivariate logistic regression analysis was used to identify the risk factors for cognitive impairment in patients with ACS. Results A total of 123 patients with ACS were enrolled in the study, including 45 (36.6%) in the cognitive impairment group and 78 (63.4%) in the non-cognitive impairment group. There were significant differences in the degree of carotid stenosis, WML severity, years of education, age, and Hcy level between the 2 groups (all P<0.05). Multivariable logistic regression analysis showed that severe carotid artery stenosis (odds ratio [OR] 3.232, 95% confidence interval [CI] 1.134-9.208; P=0.028), severe WML (OR 8.930, 95% CI 2.683-31.688; P=0.015), and hyperhomocysteinemia (OR 2.671, 95% CI 1.877-3.609; P=0.037) were the independent risk factors for cognitive impairment in patients with ACS, while years of education were an independent protective factor of cognitive impairment in patients with ACS (OR 0.607, 95%CI 0.461-0.817; P=0.043). Conclusions Cognitive impairment may occur in patients with ACS. Years of education are an independent protective factor of cognitive impairment in patients with ACS, and severe carotid artery stenosis, severe WML, and hyperhomocysteinemia are its independent risk factors. Key words: Carotid Stenosis; Cognition Disorders; Neuropsychological Tests; Risk Factors