Ultrasonographic assessment of carotid wall characteristics and cognitive functions in a community sample of 59- to 71-year-olds. The EVA Study Group.
OBJECTIVE
This study was aimed at analyzing cross-sectional relationships between cognitive performance and ultrasonographic assessment of carotid wall characteristics.


METHODS
A cohort of 1279 subjects (men, 41%) aged 59 to 71 years was recruited from the electoral rolls of the city of Nantes (western France). Cognitive performances were evaluated with the Mini-Mental State Examination (MMSE) and seven neuropsychological tests assessing attention, psychomotor rapidity, verbal abilities, memory, and visuospatial perception. For each test, subjects were classified into three performance levels with a quartile distribution: 25% highest, 25% lowest, and 50% middle. The intima-media thickness of common carotid arteries and the presence of plaques in the carotid arteries were assessed with B-mode ultrasound examination.


RESULTS
Only 28% of men and 17% of women had carotid plaques inducing moderate stenosis of the lumen ( < 40%). After adjustment for possible confounders, odds ratios for poor cognitive performance associated with plaques were above 1 for all cognitive tests in men. This association was statistically significant for the MMSE and another test assessing attention skills. There was a slight association between increase of the common carotid intima-media thickness and poor cognitive scores in men with plaques. In women, no association was found between cognitive functions and presence of plaques or intima-media thickness.


CONCLUSIONS
This study indicated a moderate association between atherosclerosis of the carotid arteries and poor cognitive functioning in men aged 59 to 71 years. In view of these moderate cross-sectional results, further studies are required to better assess the relationship between carotid atherosclerosis and cognitive impairment.
Auperin
A
A
INSERM U360, Hôpital de la Salpêtrière, Nantes, France.
Berr
C
C
Bonithon-Kopp
C
C
Touboul
P J
PJ
Ruelland
I
I
Ducimetiere
P
P
Alperovitch
A
A
D000368:Aged; D000375:Aging / Q000502:physiology*; D001161:Arteriosclerosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000473:pathology; D003071:Cognition / Q000502:physiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D012737:Sex Factors; D014463:Ultrasonography