Department of Community Medicine, University of Tromsø, Tromsø, Norway.
Cerebrovasc Dis. 2012;33(2):159-65. doi: 10.1159/000334182. Epub 2012 Jan 5.
Carotid artery atherosclerosis is a major risk factor for stroke and subsequent cognitive impairment. Prospective population studies have shown associations between carotid intima-media thickness (IMT) and stenosis and cognitive decline and dementia in elderly stroke-free persons, whereas results in the middle-aged are conflicting.
In this prospective population-based study, 4,371 stroke-free middle-aged participants underwent carotid ultrasound examination and assessment of vascular risk factors at baseline and were tested for cognitive function 7 years later. Associations between IMT, number of plaques and total plaque area and cognitive test scores on verbal memory test, digit symbol-coding test and tapping test were assessed in linear regression models.
In the multivariable analyses adjusted for sex, age, education, depression and vascular risk factors, the presence of plaques was significantly associated with lower test scores on the verbal memory test (p = 0.01) and on the digit symbol-coding test (p = 0.03). The number of plaques (p = 0.01) and the total plaque area (p = 0.02) were associated with lower scores on the verbal memory test. No significant association was seen between common carotid artery IMT and cognitive test scores. The tapping test was not associated with the carotid ultrasound variables.
In this middle-aged general population, subclinical carotid atherosclerosis measured as the presence of plaques, number of plaques and total plaque area were independent long-term predictors of lower cognitive test scores.
颈动脉粥样硬化是中风和随后认知障碍的主要危险因素。前瞻性人群研究表明，颈动脉内膜中层厚度（IMT）和狭窄与老年无中风人群的认知能力下降和痴呆之间存在关联，而中年人群的结果则存在矛盾。
在这项前瞻性的基于人群的研究中，4371 名无中风的中年参与者在基线时接受了颈动脉超声检查和血管危险因素评估，并在 7 年后进行了认知功能测试。在多变量线性回归模型中，评估了 IMT、斑块数量和总斑块面积与言语记忆测试、数字符号编码测试和敲击测试的认知测试评分之间的关联。
在调整了性别、年龄、教育、抑郁和血管危险因素后，斑块的存在与言语记忆测试（p = 0.01）和数字符号编码测试（p = 0.03）的测试分数较低显著相关。斑块数量（p = 0.01）和总斑块面积（p = 0.02）与言语记忆测试的分数较低相关。颈总动脉 IMT 与认知测试评分之间没有显著关联。敲击测试与颈动脉超声变量之间没有关联。
在这个中年普通人群中，亚临床颈动脉粥样硬化的存在、斑块数量和总斑块面积是认知测试评分较低的独立长期预测因素。
