Anbar Rayan, Jones Siana, Chaturvedi Nish, Sudre Carole, Richards Marcus, Sultan Salahaden R, Hughes Alun D
MRC unit for Lifelong Health & Ageing, Department of Population Science & Experimental Medicine, Institute of Cardiovascular Science, University College London, London, UK.
Department of Radiologic Sciences, Faculty of Applied Medical Sciences, King AbdulAziz University, Jeddah, Saudi Arabia.
Atheroscler Plus. 2024 Jan 30;55:39-46. doi: 10.1016/j.athplu.2024.01.002. eCollection 2024 Mar.
Cognitive function has an important role in determining the quality of life of older adults. Cardiovascular disease (CVD) is common in older people and may compromise cognitive performance; however, the extent to which this is related to carotid atherosclerosis is unclear.
We investigated associations between carotid atherosclerosis and cognitive function and neuroimaging markers of brain health in a UK multi-ethnic community-based sample including older people of European, South Asian, and African-Caribbean ethnicity.
Carotid plaques and intima-media thickness (cIMT) were assessed using ultrasound in 985 people (mean age 73.2y, 56 % male). Associations of carotid atherosclerosis with cognitive function (memory, executive function, language and CSI-D, a global measure of cognitive state) and neuroimaging measures (total brain volume, hippocampal volume, white matter (WM) lesion volume and coalescence score) were analysed using regression analyses, with and without adjustment for potential confounders using two models: 1) adjustment for age, sex, and ethnicity; 2) model 1 plus education, physical activity category, body mass index, hypertension, diabetes, total and high density lipoprotein cholesterol, atrial fibrillation, smoking, previous CVD, alcohol consumption, and presence of chronic kidney disease.
People with carotid plaque or higher cIMT had lower CSI-D score, poorer memory poorer executive function and higher WM lesion volume and coalescence. Language was poorer in people with plaque but was not correlated with cIMT. Associations with plaque were preserved after full adjustment (model 2) but relationships for cIMT were attenuated. Associations with other plaque characteristics were generally unconvincing after adjustment.
This multi-ethnic cohort study provides evidence that presence of carotid plaque, is associated with poorer cognitive function and brain health.
认知功能在决定老年人生活质量方面具有重要作用。心血管疾病（CVD）在老年人中很常见，可能会损害认知表现；然而，其与颈动脉粥样硬化的关联程度尚不清楚。
我们在一个以英国多民族社区为基础的样本中调查了颈动脉粥样硬化与认知功能以及脑健康神经影像学标志物之间的关联，该样本包括欧洲、南亚和非洲加勒比族裔的老年人。
对985人（平均年龄73.2岁，56%为男性）进行超声检查以评估颈动脉斑块和内膜中层厚度（cIMT）。使用回归分析来分析颈动脉粥样硬化与认知功能（记忆、执行功能、语言和CSI-D，一种认知状态的综合测量指标）以及神经影像学测量指标（全脑体积、海马体积、白质（WM）病变体积和融合评分）之间的关联，使用两个模型对潜在混杂因素进行调整和不调整：1）调整年龄、性别和种族；2）模型1加上教育程度、身体活动类别、体重指数、高血压、糖尿病、总胆固醇和高密度脂蛋白胆固醇、心房颤动、吸烟、既往心血管疾病、饮酒以及慢性肾病的存在情况。
有颈动脉斑块或较高cIMT的人CSI-D评分较低、记忆力较差、执行功能较差，且WM病变体积和融合程度较高。有斑块的人语言能力较差，但与cIMT无关。在完全调整（模型2）后，与斑块的关联仍然存在，但cIMT的关系减弱。调整后与其他斑块特征的关联通常不显著。
这项多民族队列研究提供了证据，表明颈动脉斑块的存在与较差的认知功能和脑健康相关。
