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Atherosclerosis a Signal for Brain Drain?

— Plaque burden was linked to cognitive impairment in a population-based study.

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CHICAGO -- Asymptomatic atherosclerosis could be a warning sign for cognitive impairment risk, according to a population-based study.

Individuals in the highest quartile of internal carotid wall thickness by MRI were 21% more likely to have at least mild cognitive impairment (adjusted P<0.05 for association), , of University of Texas Southwestern Medical Center in Dallas, and colleagues found.

An increasing coronary artery calcium score was predictive of large white matter intensity volume on MRI, which is also a marker for cognitive impairment, they reported in a study slated for presentation here at the annual meeting of the

Action Points

  • Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

"These results underscore the importance of identifying atherosclerosis in its early stages, not just to help preserve heart function, but also to preserve cognition and brain health," Maroules said in a statement.

"Plaque buildup in blood vessels throughout the body offers us a window into brain health," he added. "Imaging with CT and MRI has an important role in identifying patients who are at a higher risk for cognitive impairment."

The analysis included 1,903 men and women with no symptoms of cardiovascular disease (mean age 44) from the multiethnic, population-based .

Scores of less than 26 on the 30-point Montreal Cognitive Assessment were considered mild or greater cognitive impairment.

Internal and common carotid artery wall areas correlated with both the MRI and standardized cognitive testing measures of cognitive impairment (all P<0.001).

After adjustment for traditional atherosclerosis risk factors (including age, ethnicity, sex, diabetes, hypertension, smoking, and body mass index), increasing internal carotid artery wall area remained associated with white matter hyperintensity (P=0.04). It also was associated with 12% higher odds per standard deviation of a cognitive score in the range of at least mild impairment (P=0.04).

The association with increasing common carotid artery wall area lost significance for predicting cognitive impairment on multivariate analysis (P=0.5).

Increasing coronary artery calcium score predicted 19% higher odds per standard deviation of having a white matter hyperintensity at least one standard deviation above the age-adjusted median (P=0.02).

"Subclinical atherosclerosis may predict cognitive decline independent of traditional cardiovascular risk factors," the researchers concluded. "Different sites and measures of atherosclerosis may have different sensitivities for predicting cognitive dysfunction."

Disclosures

Maroules disclosed no relevant relationships with industry.

Primary Source

Radiological Society of North America meeting

Source Reference: Maroules C, et al "Subclinical atherosclerosis and cognitive impairment: The Dallas Heart Study" RSNA 2014; SSA15-01.