Department of Neurology, Daping Hospital, The Third Military Medical University, Yangzi River Street, Yuzhong District, Chongqing 400042, China.
J Clin Neurosci. 2013 Nov;20(11):1571-5. doi: 10.1016/j.jocn.2013.02.026. Epub 2013 Aug 24.
Carotid artery atherosclerosis may cause increased intima-media thickness (IMT), plaque formation, and vessel stenosis or occlusion. However, the association between carotid artery atherosclerosis and cognitive impairment remains uncertain. This study explored the effects of IMT and carotid artery stenosis on cognitive function in an elderly Chinese non-stroke population. A total of 2015 patients were recruited. The IMT of carotid arteries and the presence of plaques and stenosis in carotid arteries were assessed with B-mode ultrasound examination. Cognitive performance was evaluated with neuropsychological tests. The cross-sectional relationships between cognitive performance and carotid wall characteristics were analyzed. Carotid artery atherosclerosis (IMT>1.0) and stenosis were found in 86% and 51% of patients, respectively. Cognitive impairment was found in 356 (17.7%) patients. After adjustment for possible confounders, IMT (odds ratio [OR]=1.96; 95% confidence interval [CI] 1.23-3.16) and hyperdense plaque (OR=4.72; 95% CI 2.56-11.2) were associated with poor cognitive performance. Patients with severe (≥70%) carotid artery stenosis had a lower Mini-Mental State Examination score compared with the mild to modest (40-70%) carotid artery stenosis group. Cognitive performance differed between patients with left and right carotid artery stenosis, but no differences were observed between patients with severe left and right carotid artery stenosis. This study indicates that carotid artery atherosclerosis is correlated with cognitive impairment in the elderly Chinese population. A larger sample size across multiple centers and a longitudinal study are required to further explore the impact of carotid artery atherosclerosis on cognition in the elderly population.
颈动脉粥样硬化可能导致内膜-中层厚度（IMT）增加、斑块形成以及血管狭窄或闭塞。然而，颈动脉粥样硬化与认知障碍之间的关联尚不确定。本研究旨在探讨中国老年非卒中人群中 IMT 和颈动脉狭窄对认知功能的影响。共纳入 2015 例患者。采用 B 型超声检查评估颈动脉内-中膜厚度（IMT）以及颈动脉斑块和狭窄情况。采用神经心理学测试评估认知功能。分析认知表现与颈动脉壁特征之间的横断面关系。结果显示，86%的患者存在颈动脉粥样硬化（IMT>1.0），51%的患者存在颈动脉狭窄。356 例（17.7%）患者存在认知障碍。在调整了可能的混杂因素后，IMT（比值比[OR]=1.96；95%置信区间[CI] 1.23-3.16）和高密度斑块（OR=4.72；95%CI 2.56-11.2）与认知功能不良相关。与轻度至中度（40-70%）颈动脉狭窄组相比，严重（≥70%）颈动脉狭窄患者的简易精神状态检查评分较低。左、右侧颈动脉狭窄患者的认知表现存在差异，但严重左、右侧颈动脉狭窄患者之间无差异。综上所述，本研究表明颈动脉粥样硬化与中国老年人群的认知障碍相关。需要更大的多中心样本量和纵向研究来进一步探讨颈动脉粥样硬化对老年人群认知的影响。
