Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Soto Street Building Suite 202Y, 2001 North Soto St, Los Angeles, CA, 90089, USA.
Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA.
Alzheimers Res Ther. 2022 May 7;14(1):63. doi: 10.1186/s13195-022-00997-7.
The combined effects of increased life expectancy and the considerable number of persons reaching old age will magnify the dementia epidemic in the USA. Demonstration that subclinical atherosclerosis precedes and is associated with cognitive impairment suggests a modifiable risk factor for age-associated cognitive impairment and dementia. The purpose of this study is to determine whether subclinical atherosclerosis as measured by carotid artery intima-media thickness (CIMT) is associated with changes in cognitive function over time in older adults.
This study combined longitudinal data from three clinical trials conducted between 2000 and 2013: the B-Vitamin Atherosclerosis Intervention Trial (BVAIT), the Women's Isoflavone Soy Health (WISH) trial, and the Early versus Late Intervention Trial with Estradiol (ELITE). Participants were recruited from the general population in the Greater Los Angeles area and were free of cardiovascular disease and diabetes; no cognitive or psychiatric exclusion criteria were specified. The same standardized protocol for ultrasound image acquisition and measurement of CIMT was used in all trials. CIMT measurements performed at baseline and 2.5 years were used in these analyses. Cognitive function was assessed at baseline and 2.5 years using a battery of 14 standardized cognitive tests. All clinical trials were conducted at the University of Southern California Atherosclerosis Research Unit, Los Angeles, and had at least 2.5 years of cognitive follow-up.
A total of 308 men and 1187 women, mean age of 61 years, were included in the combined longitudinal dataset for the primary analysis. No associations were found between CIMT and cognitive function at baseline or at 2.5 years. There was a weak inverse association between CIMT measured at baseline and change in global cognition assessed over 2.5 years (β (SE) = - 0.056 (0.028) units per 0.1 mm CIMT, 95% CI - 0.110, - 0.001, p = 0.046). No associations between CIMT at baseline and changes in executive function, verbal memory, or visual memory were found.
In this sample of healthy older adults, our findings suggest an association between subclinical atherosclerosis and change in global cognitive function over 2.5 years. Stronger associations were observed longitudinally over 2.5 years than cross-sectionally. When analysis was stratified by age group (<65 and ≥65 years old), the inverse association remained statistically significant for participants in the older age group. Subclinical atherosclerosis of the carotid artery may be a modifiable correlate of cognitive decline in middle and older age.
BVAIT, NCT00114400 . WISH, NCT00118846 . ELITE, NCT00114517 .
预期寿命的延长和大量步入老年的人群，将使美国的痴呆症流行情况更为严重。无症状性动脉粥样硬化先于认知障碍并与之相关的证据表明，这种情况是可改变的与年龄相关的认知障碍和痴呆的危险因素。本研究旨在确定无症状性动脉粥样硬化（通过颈动脉内膜中层厚度[CIMT]测量）是否与老年人认知功能随时间的变化有关。
本研究将 2000 年至 2013 年期间进行的三项临床试验的纵向数据结合起来：维生素 B 动脉粥样硬化干预试验（BVAIT）、妇女异黄酮大豆健康研究（WISH）试验和雌二醇早期与晚期干预试验（ELITE）。参与者是从大洛杉矶地区的一般人群中招募的，没有心血管疾病和糖尿病；没有指定认知或精神科的排除标准。所有试验均使用相同的标准化超声图像采集和 CIMT 测量方案。这些分析中使用了基线和 2.5 年的 CIMT 测量值。使用 14 项标准化认知测试的测试套件在基线和 2.5 年时评估认知功能。所有临床试验均在南加州大学动脉粥样硬化研究单位进行，洛杉矶，认知随访至少 2.5 年。
共有 308 名男性和 1187 名女性，平均年龄为 61 岁，被纳入主要分析的综合纵向数据集。在基线或 2.5 年时，CIMT 与认知功能之间没有关联。基线 CIMT 与 2.5 年内整体认知评估的变化之间存在弱负相关（β（SE）=-0.056（0.028）单位/0.1mm CIMT，95%CI-0.110，-0.001，p=0.046）。在基线 CIMT 与执行功能、言语记忆或视觉记忆的变化之间未发现关联。
在本健康的老年人群样本中，我们的研究结果表明无症状性动脉粥样硬化与 2.5 年内的整体认知功能变化之间存在关联。在 2.5 年内的纵向研究中观察到的关联强于横断面研究。当按年龄组（<65 岁和≥65 岁）进行分析时，在年龄较大的组中，这种负相关仍然具有统计学意义。颈动脉的亚临床动脉粥样硬化可能是中年和老年认知能力下降的可改变相关因素。
BVAIT，NCT00114400。WISH，NCT00118846。ELITE，NCT00114517。
