Presenter of 2 Presentations
THE EFFECTS OF CAROTID ARTERY STIFFNESS ON CEREBRAL SMALL VESSEL DISEASE AND COGNITION
THE EFFECTS OF CAROTID ARTERY STIFFNESS ON CEREBRAL SMALL VESSEL DISEASE AND COGNITION
Abstract
Background and Aims
Carotid artery stiffness is associated with cognitive impairment and dementia, however, the underlying mechanism remains unknown. We examined the associations of carotid artery stiffness with cerebral small vessel disease (CSVD) markers, cognitive impairment, dementia subtypes, and cognition.
Methods
A total of 272 participants from a memory-clinic underwent carotid ultrasonography, 3T brain MRI and detailed neuropsychological assessment. Carotid ultrasonography was used to assess arterial compliance (AC), pressure-strain elastic modulus (Ep), β-index, augmentation index (AI), and pulse wave velocity-β (PWV-β). Brain MRI were graded for CSVD markers including white matter hyperintensities (WMH), lacunes and cerebral microbleeds (CMBs). Participants were classified as having no cognitive impairment, cognitive impairment no dementia, or dementia subtyped as Alzheimer’s disease (AD) and vascular dementia (VaD). Cognition was assessed using NINDS–Canadian Stroke Network harmonization battery.
Results
β-index (β=0.73, P<0.001), Ep (β=0.86, P<0.001), and PWV-β (β=0.83, P<0.001) were independently associated with WMH. Ep (OR=1.42, 95%CI=1.05–1.93), and PWV-β (OR=1.43, 95%CI=1.05–1.94) were associated with lacunes. Ep was associated with AD (OR=1.59, 95%CI=1.01–2.73) and VaD (OR=2.23, 95%CI=1.04–5.94). PWV-β was also associated with VaD (OR=2.24, 95%CI=1.07–5.62). All carotid artery stiffness measurements, except AI, were associated with worse performance in global cognition, visuomotor speed and memory. These associations became attenuated but remained significant with global cognition after adjusting for CSVD markers.
Conclusions
Carotid artery stiffening is associated with WMH, lacunes, etiologic subtypes of dementia, and global cognition independent of CSVD. Elevated carotid artery stiffness may help identify patients at risk for developing CSVD and dementia.