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Intracranial atherosclerosis and dementia: The Atherosclerosis Risk in Communities (ARIC) Study.

TitleIntracranial atherosclerosis and dementia: The Atherosclerosis Risk in Communities (ARIC) Study.
Publication TypeJournal Article
Year of Publication2017
AuthorsDearborn JL, Zhang Y, Qiao Y, Suri MFareed K, Liu L, Gottesman RF, Rawlings AM, Mosley TH, Alonso A, Knopman DS, Guallar E
Secondary AuthorsWasserman BA
JournalNeurology
Volume88
Issue16
Pagination1556-1563
Date Published2017 Apr 18
ISSN1526-632X
KeywordsAged, 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
Abstract

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.

DOI10.1212/WNL.0000000000003837
Alternate JournalNeurology
PubMed ID28330958
PubMed Central IDPMC5395073
Grant ListR00 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