Department of Neurology, The University of Tokyo Hospital, Tokyo, Japan.
Center for Epidemiology and Preventive Medicine, The University of Tokyo Hospital, Tokyo, Japan.
Geriatr Gerontol Int. 2018 Jan;18(1):65-71. doi: 10.1111/ggi.13142. Epub 2017 Aug 4.
To clarify whether carotid atherosclerosis and its risk factors are associated with cognitive decline.
We evaluated 206 individuals who visited our center for health screening. We carried out physical examinations, blood tests, intima-media thickness (IMT) measurement by carotid ultrasonography, brain magnetic resonance imaging scanning and cognitive function assessments. A total of 30 individuals, who had significant cerebrovascular lesions detected in magnetic resonance imaging scans, were excluded. To detect early cognitive decline, we defined "cognitive impairment (CI)" when a patient satisfied at least one of three criteria. These were Mini-Mental State Examination score <24, clock-drawing test score <4 coexisting with forgetfulness and Wechsler Memory Scale-revised delayed recall score below the normal range for the duration of education (>16 years of education: ≥9, 10-15 years: ≥5, 0-9 years: ≥3).
Among 176 individuals, 27 were placed in the CI group. IMT was significantly higher in the CI group as compared with the non-CI group (mean ± SD: 2.0 ± 1.0 vs 1.7 ± 0.7, P = 0018 by Student's t-test). Other atherosclerotic risk factors, such as blood pressure, low-density lipoprotein cholesterol, and hemoglobin A1c, were not significantly different between the two groups. In multivariate analysis, maximum IMT was associated with impaired immediate recall score on Wechsler Memory Scale-revised, independent of the presence of deep white matter hyperintensities on the magnetic resonance imaging scan.
Subclinical carotid atherosclerosis, defined as thickened IMT, could be a marker for early stages of CI, especially for immediate memory recall. The impairment is presumably caused by inducing cerebral microvascular dysfunction in the frontal lobe. Geriatr Gerontol Int 2018; 18: 65-71.
阐明颈动脉粥样硬化及其危险因素是否与认知能力下降有关。
我们评估了 206 名来中心进行健康筛查的个体。我们进行了体格检查、血液检查、颈动脉超声内膜-中层厚度（IMT）测量、脑磁共振成像扫描和认知功能评估。共有 30 名个体在磁共振成像扫描中发现有明显的脑血管病变而被排除在外。为了检测早期认知能力下降，当患者满足以下至少一项标准时，我们将其定义为“认知障碍（CI）”：简易精神状态检查评分<24、画钟测验评分<4 且伴有健忘、韦氏记忆量表修订版延迟回忆评分低于教育年限的正常范围（>16 年教育：≥9、10-15 年：≥5、0-9 年：≥3）。
在 176 名个体中，27 名被纳入 CI 组。与非 CI 组相比，CI 组的 IMT 显著更高（均值±标准差：2.0±1.0 比 1.7±0.7，P=0.018，Student's t 检验）。两组之间其他动脉粥样硬化危险因素，如血压、低密度脂蛋白胆固醇和糖化血红蛋白，无显著差异。在多变量分析中，最大 IMT 与韦氏记忆量表修订版即时回忆评分受损相关，与磁共振成像扫描上是否存在深部白质高信号无关。
亚临床颈动脉粥样硬化，定义为 IMT 增厚，可能是 CI 早期阶段的标志物，尤其是即时记忆回忆受损。这种损伤可能是由于额叶脑微血管功能障碍引起的。老年医学与老年病学杂志 2018；18：65-71。
