The association between carotid intima-media thickness and cognitive performance is affected by intracranial artery stenosis in Chinese elderly people: An outpatient-based study

Abstract

Background and AimsThe association between carotid intima-media thickness (cIMT) and cognitive function remains controversial, and whether this relationship is affected by intracranial artery stenosis (ICAS) remains unclear. We investigated these questions among elderly participants who sought health consultations in an outpatient clinic. MethodsWe conducted a cross-sectional study based on participants from an outpatient clinic, enrolling residents over 60 years of age seeking outpatient services because of abnormal transcranial Doppler reports at Shandong Provincial Third Hospital in Jinan, Shandong province. We performed physical examinations, blood tests, cIMT measurement using carotid ultrasonography, ICAS measurement using brain magnetic resonance angiography scanning, and global cognitive function assessment using the Montreal Cognitive Assessment (MoCA)in the outpatient clinic from May 2020 to December 2020. We subsequently performed a regression analysis to explore the relationship between cIMT and cognitive function and a stratified analysis to explore whether the relationship was different between the ICAS and non-ICAS participants. ResultsIn total, 167 participants (age: 65.56 ± 10.39 years, female: 53.89%) were included in the present study. The MoCA score was significantly lower in the intimal thickening group (cIMT ≥ 1.0 mm) than in the normal group (mean [SD]: 16.23 [5.16] vs. 19.97 [4.59], P < 0.001). Univariate analysis showed that a greater cIMT was negatively correlated with cognitive function. After adjustment for several potential confounders in the multivariable analyses, the association between cIMT and cognitive function disappeared. When further stratified by ICAS, a negative association between increased cIMT (cIMT ≥ 1.0 mm) and cognitive function was found in those without ICAS (β: −2.80 [-5.13, −0.48], p = 0.021); however, in subjects with ICAS, the relationship between cIMT and cognitive function was insignificant. ConclusionGreater cIMT was associated with low cognitive function in participants without ICAS who sought consultation due to abnormal transcranial Doppler reports in outpatient clinics.