|Title||Intracranial atherosclerosis and dementia: The Atherosclerosis Risk in Communities (ARIC) Study.|
|Publication Type||Journal Article|
|Year of Publication||2017|
|Authors||Dearborn JL, Zhang Y, Qiao Y, Suri MFareed K, Liu L, Gottesman RF, Rawlings AM, Mosley TH, Alonso A, Knopman DS, Guallar E|
|Secondary Authors||Wasserman BA|
|Date Published||2017 Apr 18|
|Keywords||Aged, Brain, Cognitive Dysfunction, Cross-Sectional Studies, Dementia, Female, Humans, Interviews as Topic, Intracranial Arteriosclerosis, Logistic Models, Longitudinal Studies, Male, Neuropsychological Tests, Prevalence, Risk, Risk Factors, Smoking, United States|
OBJECTIVE: To explore the association of intracranial atherosclerotic disease (ICAD) with mild cognitive impairment (MCI) and dementia.
METHODS: From 2011 to 2013, 1,744 participants completed high-resolution vessel wall MRI from the population-based Atherosclerosis Risk in Communities Study by a sampling strategy that allowed weighting back to the cohort. We defined ICAD by plaque features (presence, territory, stenosis, number). Trained clinicians used an algorithm incorporating information from interviews and neuropsychological and neurologic examinations to adjudicate for MCI and dementia. We determined the relative prevalence ratio (RPR) of MCI or dementia after adjusting for risk factors at midlife using multinomial logistic regression.
RESULTS: A total of 601 (34.5%) participants had MCI (mean age ± SD, 76.6 ± 5.2 years), 83 (4.8%) had dementia (79.1 ± 5.3 years), and 857 (49.1%) were current or former smokers. Anterior cerebral artery (ACA) plaque (adjusted RPR 3.81, 95% confidence interval [CI] 1.57-9.23), >2 territories with plaque (adjusted RPR 2.12, 95% CI 1.00-4.49), and presence of stenosis >50% (adjusted RPR 1.92, 95% CI 1.01-3.65) were associated with increased prevalence of dementia in separate models. Posterior cerebral artery plaque was associated with MCI but did not reach statistical significance for dementia (adjusted RPR MCI 1.43, 95% CI 1.04-1.98; adjusted RPR dementia 1.58, 95% CI 0.79-2.85). There were no associations with middle cerebral artery atherosclerotic lesions or cognitive impairment. Many participants had plaque in >1 territory (n = 291, 46%) and participants with ACA plaques (n = 69) had the greatest number of plaques in other territories (mean 6.0, SD 4.4).
CONCLUSIONS: This study demonstrates associations between ICAD and clinical MCI and dementia.
|PubMed Central ID||PMC5395073|
|Grant List||R00 HL106232 / HL / NHLBI NIH HHS / United States |
U01 HL096812 / HL / NHLBI NIH HHS / United States
U01 HL096917 / HL / NHLBI NIH HHS / United States
U01 HL096902 / HL / NHLBI NIH HHS / United States
T32 HL007024 / HL / NHLBI NIH HHS / United States
U01 HL096814 / HL / NHLBI NIH HHS / United States
R01 HL105930 / HL / NHLBI NIH HHS / United States
U01 HL096899 / HL / NHLBI NIH HHS / United States
K24 AG052573 / AG / NIA NIH HHS / United States