Wendell Carrington Rice, Zonderman Alan B, Metter E Jeffrey, Najjar Samer S, Waldstein Shari R
Department of Psychology, University of Maryland, Baltimore County, Baltimore, MD 21250, USA.
Stroke. 2009 Oct;40(10):3180-5. doi: 10.1161/STROKEAHA.109.557280. Epub 2009 Jul 30.
Though clinical cardiovascular and cerebrovascular diseases are established risk factors for cognitive decline and dementia, less is known about the relations between vascular health and cognition among individuals without these diseases. Carotid intimal medial thickness (IMT), a measure of subclinical vascular disease, is associated with concurrent decrements in cognitive function, but relatively little research has examined longitudinal relations between carotid IMT and prospective cognitive decline.
We examined relations of carotid IMT to prospective trajectories of cognitive function among 538 (aged 20 to 93, 39% male, 66% white) participants in the Baltimore Longitudinal Study of Aging (BLSA) free of known cardiovascular, cerebrovascular, and neurological disease. Participants underwent initial carotid ultrasonography and repeat neuropsychological testing on up to 8 occasions over up to 11 years of follow-up. Mixed-effects regression analyses were adjusted for age, gender, race, education, mean arterial pressure, body mass index, total cholesterol, smoking, depressive symptoms, and cardiovascular medication use.
Individuals with greater carotid IMT displayed accelerated decline in performance over time on multiple tests of verbal and nonverbal memory, as well as a test of semantic association fluency and executive function.
Carotid IMT predicts accelerated cognitive decline, particularly in the domain of memory, among community-dwelling individuals free of vascular and neurological disease.
尽管临床心血管和脑血管疾病是认知功能下降和痴呆的既定风险因素，但对于无这些疾病个体的血管健康与认知之间的关系，人们了解较少。颈动脉内膜中层厚度（IMT）是亚临床血管疾病的一项指标，与认知功能的同时下降有关，但相对较少的研究探讨了颈动脉IMT与前瞻性认知功能下降之间的纵向关系。
我们在巴尔的摩纵向衰老研究（BLSA）中，对538名（年龄20至93岁，男性占39%，白人占66%）无已知心血管、脑血管和神经系统疾病的参与者，研究了颈动脉IMT与认知功能前瞻性轨迹之间的关系。参与者接受了初始颈动脉超声检查，并在长达11年的随访中进行了多达8次的重复神经心理学测试。混合效应回归分析对年龄、性别、种族、教育程度、平均动脉压、体重指数、总胆固醇、吸烟、抑郁症状和心血管药物使用情况进行了校正。
颈动脉IMT较高的个体在言语和非言语记忆的多项测试以及语义联想流畅性和执行功能测试中，随着时间推移表现出加速下降。
在无血管和神经系统疾病的社区居住个体中，颈动脉IMT可预测认知功能加速下降，尤其是在记忆领域。
