Inserm, CESP Centre for Research in Epidemiology and Population Health, UMR-S1018, Hormones and Cardiovascular Disease, University Paris Sud, Villejuif, France.
Inserm, UMR-S 970, Paris Descartes University, Sorbonne Paris Cité, Paris Cardiovascular Research Center, Paris, France; Assistance Publique - Hôpitaux de Paris, Hôpital Broca, Paris, France.
Alzheimers Dement. 2015 Mar;11(3):239-48. doi: 10.1016/j.jalz.2014.07.160. Epub 2014 Dec 12.
The contribution of carotid atherosclerosis to incident dementia remains unclear. We examined the association between carotid plaques (CP) and common carotid intima media thickness (CCA-IMT) with incident dementia and its subtypes, and their added value for dementia risk prediction.
At baseline, 6025 dementia-free subjects aged 65-86 years underwent bilateral carotid ultrasonography measures of CP and plaque-free CCA-IMT. Subjects were followed-up over 7 years for the detection of dementia.
After a mean 5.4 years of follow-up, 421 subjects developed dementia including 272 Alzheimer's disease and 83 vascular/mixed dementia (VaD). Only CP were independently related to VaD (HR(≥2 sites with plaques) = 1.92; 95% confidence interval or CI = 1.13-3.22) and improved VaD risk prediction (continuous Net Reclassification Index = 30.1%; 95% CI = 8.4-51.7) beyond known dementia risk factors. Accounting for stroke or competing risk by death marginally modified the results.
In older adults, CP are independent predictors of incident VaD and may improve VaD risk prediction.
颈动脉粥样硬化对痴呆事件的贡献仍不清楚。我们研究了颈动脉斑块（CP）和颈总动脉内膜中层厚度（CCA-IMT）与痴呆及其亚型事件的相关性，以及它们对痴呆风险预测的附加价值。
在基线时，6025 名无痴呆的 65-86 岁受试者接受了双侧颈动脉超声检查 CP 和无斑块 CCA-IMT。对受试者进行了 7 年的随访，以检测痴呆的发生。
在平均 5.4 年的随访后，421 名受试者发生了痴呆，包括 272 名阿尔茨海默病和 83 名血管性/混合性痴呆（VaD）。只有 CP 与 VaD 独立相关（HR（≥2 个斑块部位）= 1.92；95%置信区间或 CI = 1.13-3.22），并改善了 VaD 风险预测（连续净重新分类指数 = 30.1%；95% CI = 8.4-51.7），超过了已知的痴呆风险因素。通过死亡考虑到中风或竞争风险，结果略有改变。
在老年人中，CP 是 VaD 事件的独立预测因子，可能改善 VaD 风险预测。
