Diagnostic Radiology, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Makkah, Saudi Arabia.
MRC Unit for Lifelong Health and Aging, UCL Institute of Cardiovascular Science, University College London, London, UK.
BMJ Open. 2022 Apr 19;12(4):e055131. doi: 10.1136/bmjopen-2021-055131.
To determine associations between carotid atherosclerosis assessed by ultrasound and the Mini-Mental State Examination (MMSE), a measure of global cognitive function.
Systematic review and meta-analysis.
MEDLINE and EMBASE databases were searched up to 1 May 2020 to identify studies assessed the associations between asymptomatic carotid atherosclerosis and the MMSE. Studies reporting OR for associations between carotid plaque or intima-media thickness (cIMT) and dichotomised MMSE were meta-analysed. Publication bias of included studies was assessed.
A total of 31 of 378 reviewed articles met the inclusion criteria; together they included 27 738 participants (age 35-95 years). Fifteen studies reported some evidence of a positive association between measures of atherosclerosis and poorer cognitive performance in either cross-sectional or longitudinal studies. The remaining 16 studies found no evidence of an association. Seven cross-sectional studies provided data suitable for meta-analysis. Meta-analysis of three studies that assessed carotid plaque (n=3549) showed an association between the presence of plaque and impaired MMSE with pooled estimate for the OR (95% CI) being 2.72 (0.85 to 4.59). An association between cIMT and impaired MMSE was reported in six studies (n=4443) with a pooled estimate for the OR (95% CI) being 1.13 (1.04 to 1.22). Heterogeneity across studies was moderate to small (carotid plaque with MMSE, I=40.9%; cIMT with MMSE, I=4.9%). There was evidence of publication bias for carotid plaque studies (p=0.02), but not cIMT studies (p=0.2).
There is some, limited cross-sectional evidence indicating an association between cIMT and poorer global cognitive function assessed with MMSE. Estimates of the association between plaques and poor cognition are too imprecise to draw firm conclusions and evidence from studies of longitudinal associations between carotid atherosclerosis and MMSE is limited.
CRD42021240077.
通过超声评估颈动脉粥样硬化与简易精神状态检查（MMSE）的关系，MMSE 是一种评估整体认知功能的方法。
系统评价和荟萃分析。
检索 MEDLINE 和 EMBASE 数据库，以确定评估无症状性颈动脉粥样硬化与 MMSE 之间关联的研究。对报告颈动脉斑块或内-中膜厚度（cIMT）与 MMSE 二分变量之间关联的比值比（OR）的研究进行荟萃分析。评估纳入研究的发表偏倚。
378 篇综述文章中共有 31 篇符合纳入标准；共纳入 27738 名参与者（年龄 35-95 岁）。15 项研究报告了在横断面或纵向研究中，动脉粥样硬化测量指标与认知功能下降之间存在正相关的一些证据。其余 16 项研究未发现相关性。7 项横断面研究提供了适合荟萃分析的数据。对 3 项评估颈动脉斑块的研究进行荟萃分析（n=3549）显示，斑块的存在与 MMSE 受损之间存在关联，OR（95%CI）的合并估计值为 2.72（0.85 至 4.59）。6 项研究（n=4443）报告了 cIMT 与 MMSE 受损之间存在关联，OR（95%CI）的合并估计值为 1.13（1.04 至 1.22）。研究之间的异质性为中等至较小（颈动脉斑块与 MMSE，I=40.9%；cIMT 与 MMSE，I=4.9%）。有证据表明，颈动脉斑块研究存在发表偏倚（p=0.02），但 cIMT 研究不存在（p=0.2）。
有一些有限的横断面证据表明，cIMT 与 MMSE 评估的整体认知功能下降之间存在关联。斑块与认知能力下降之间关联的估计值过于不精确，无法得出明确的结论，并且颈动脉粥样硬化与 MMSE 之间纵向关联的研究证据有限。
CRD42021240077。
