Longitudinal associations of carotid artery stiffness with progression of cerebrovascular disease, incident dementia and cognitive decline in older adults.
Caroline Robert, Lieng-Hsi Ling, Eugene S J Tan, Narayanaswamy Venketasubramanian, Shir Lynn Lim, Lingli Gong, Josephine Lunaria Berboso, Arthur Mark Richards, Christopher Chen, Saima Hilal
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引用次数: 0
Abstract
Background: Carotid artery stiffness is associated with cerebrovascular disease (CeVD) and cognitive impairment, but evidence for its longitudinal effects on progression of CeVD and cognitive decline are limited.
Objectives: To evaluate the longitudinal associations of carotid artery stiffness with CeVD progression, incident dementia, and cognitive decline.
Design: Longitudinal analyses from a memory-clinic cohort with a follow-up of 2 years.
Setting: A memory-clinic study.
Participants: 194 participants (mean age=80, 63 % female) with or without cognitive impairments provided consent to take part in the study.
Measurements: Participants underwent carotid ultrasonography, brain MRI, and neuropsychological assessments were at baseline and follow-up. Carotid stiffness measures included ß-index, elastic modulus (Ep), and pulse wave velocity-ß (PWV-ß). CeVD markers included white matter hyperintensities (WMH), lacunes, cerebral microbleeds (CMBs) and cortical infarcts. Cognition was assessed with a neuropsychological battery.
Results: After 2 years, incident CeVD cases included lacunes (15.7 %), CMBs (23.8 %), and cortical infarcts (7.6 %). ß-index (ß=0.78, p < 0.001), Ep (ß=0.94, p < 0.001), and PWV-ß (ß=0.15, p = 0.003) were independently associated with WMH progression. Ep (ß=-0.15, p = 0.007) and PWV-ß (ß=-3.68, p = 0.007) were independently associated with visuomotor speed decline. No association was found with incident lacunes, CMBs or dementia.
Conclusion: Carotid stiffness progression is associated with WMH progression and visuomotor speed decline.
背景：颈动脉僵硬与脑血管疾病（CeVD）和认知功能障碍相关，但其对CeVD进展和认知功能下降的纵向影响证据有限。目的：评估颈动脉僵硬度与CeVD进展、痴呆事件和认知能力下降的纵向关联。设计：对一个随访2年的记忆诊所队列进行纵向分析。背景：记忆诊所研究。参与者：有或没有认知障碍的194名参与者（平均年龄=80岁，63%为女性）同意参加研究。测量：参与者在基线和随访期间接受了颈动脉超声检查、脑MRI和神经心理学评估。颈动脉刚度测量包括ß-指数、弹性模量（Ep）和脉搏波速度-ß （PWV-ß）。CeVD标志物包括白质高信号（WMH）、脑凹痕、脑微出血（CMBs）和皮质梗死。认知用神经心理学电池评估。结果：2年后，CeVD的发生率包括腔隙（15.7%）、CMBs（23.8%）和皮质梗死（7.6%）。ß-index （ß=0.78, p < 0.001）、Ep （ß=0.94, p < 0.001）和PWV-ß （ß=0.15, p = 0.003）与WMH进展独立相关。Ep （ß=-0.15, p = 0.007）和PWV-ß （ß=-3.68, p = 0.007）与视运动速度下降独立相关。未发现与偶发腔隙、CMBs或痴呆相关。结论：颈动脉僵硬进展与WMH进展和视运动速度下降有关。
期刊介绍：
The JPAD Journal of Prevention of Alzheimer’Disease will publish reviews, original research articles and short reports to improve our knowledge in the field of Alzheimer prevention including: neurosciences, biomarkers, imaging, epidemiology, public health, physical cognitive exercise, nutrition, risk and protective factors, drug development, trials design, and heath economic outcomes.JPAD will publish also the meeting abstracts from Clinical Trial on Alzheimer Disease (CTAD) and will be distributed both in paper and online version worldwide.We hope that JPAD with your contribution will play a role in the development of Alzheimer prevention.
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