一般人群中的认知障碍与颅内动脉粥样硬化性狭窄。
Cognitive impairment and intracranial atherosclerotic stenosis in general population.
机构信息
From the Department of Neurology (M.F.K.S., A I.Q.) and School of Public Health (J.Z., H.C.), Division of Biostatistics, University of Minnesota, Minneapolis; Department of Epidemiology (A.A.), Rollins School of Public Health, Emory University, Atlanta, GA; Departments of Epidemiology (R.F.G., A.R.S.) and Medicine (R.F.G.) and Welch Center for Prevention, Epidemiology, and Clinical Research (R.F.G.), Johns Hopkins Bloomberg School of Public Health; Russell H. Morgan Department of Radiology and Radiological Sciences (Y.Q., B.A.W.), Johns Hopkins Hospital; Department of Neurology (R.F.G.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Biostatistics (L.W.), University of North Carolina at Chapel Hill; and Department of Geriatrics (T.M.), Louisiana State University, Baton Rouge.
出版信息
Neurology. 2018 Apr 3;90(14):e1240-e1247. doi: 10.1212/WNL.0000000000005250. Epub 2018 Mar 9.
OBJECTIVE
To investigate the association between asymptomatic intracranial atherosclerosis and cognitive impairment in the Atherosclerosis Risk in Communities (ARIC) cohort.
METHODS
ARIC participants underwent high-resolution 3T magnetic resonance angiography and a neuropsychology battery and neurologic examination adjudicated by an expert panel to detect mild cognitive impairment (MCI) and dementia. We adjusted for demographic and vascular risk factors in weighted logistic regression analysis, accounting for stratified sampling design and attrition, to determine the association of intracranial atherosclerotic stenosis (ICAS) with cognitive impairment.
RESULTS
In 1,701 participants (mean age 76 ± 5.3, 41% men, 71% whites, 29% blacks) with adequate imaging quality and no history of stroke, MCI was identified in 578 (34%) and dementia in 79 (4.6%). In white participants, after adjustment for demographic and vascular risk factors, ICAS ≥50% (vs no ICAS) was strongly associated with dementia (odds ratio [OR] 4.1, 95% confidence interval [CI] 1.7-10.0) and with any cognitive impairment (OR 1.7, 95% CI 1.1-2.8). In contrast, no association was found between ICAS ≥50% and MCI or dementia in blacks, although the sample size was limited and estimates were imprecise.
CONCLUSION
Our results suggest that asymptomatic ICAS is independently associated with cognitive impairment and dementia in whites.
目的
在动脉粥样硬化风险社区（ARIC）队列中研究无症状性颅内动脉粥样硬化与认知障碍的关系。
方法
ARIC 参与者接受了高分辨率 3T 磁共振血管造影和神经心理学测试以及由专家小组进行的神经学检查，以检测轻度认知障碍（MCI）和痴呆症。我们在加权逻辑回归分析中调整了人口统计学和血管危险因素，考虑了分层抽样设计和损耗，以确定颅内动脉粥样硬化狭窄（ICAS）与认知障碍的关系。
结果
在 1701 名（平均年龄 76±5.3 岁，41%男性，71%白人，29%黑人）具有足够成像质量且无中风史的参与者中，578 名（34%）患有 MCI，79 名（4.6%）患有痴呆症。在白人参与者中，在调整人口统计学和血管危险因素后，ICAS≥50%（与无 ICAS 相比）与痴呆症（比值比 [OR] 4.1，95%置信区间 [CI] 1.7-10.0）和任何认知障碍（OR 1.7，95% CI 1.1-2.8）密切相关。相比之下，在黑人中，ICAS≥50%与 MCI 或痴呆症之间没有关联，尽管样本量有限且估计值不精确。
结论
我们的研究结果表明，无症状性 ICAS 与白种人的认知障碍和痴呆症独立相关。
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