title: Risk of cognitive decline in older patients after carotid endarterectomy: an observational study.
abstract: OBJECTIVE
  To determine whether patients undergoing carotid endarterectomy (CE) for symptomatic left internal carotid artery (LICA) stenosis have greater risk of cognitive decline than patients with asymptomatic LICA disease or right internal carotid artery (RICA) disease.
  
  
  METHODS
  Observational.
  
  
  METHODS
  Vascular surgery day hospital.
  
  
  METHODS
  The analysis included 103 patients (mean age 72.6+/-7.0, 73 men), of whom 50 had LICA disease (29 symptomatic).
  
  
  METHODS
  Cognitive function was evaluated (age- and education-adjusted Mini-Mental State Examination (MMSE), and Clock tests (CLOX1 and 2)) at baseline and at the end of the study period (average follow-up+/-standard deviation 44.4+/-14.3 months) in a sample of patients aged 65 and older, free from cognitive impairment, consecutively undergoing CE.
  
  
  RESULTS
  At the end of the study period, MMSE, CLOX1, and CLOX2 scores were significantly lower in patients with symptomatic LICA disease (P<.001, P<.001, and P=.002, respectively) and not in the other groups of patients. Patients with symptomatic LICA disease had greater risk of cognitive decline than other individuals according to MMSE score (F=5.18, P=.002) or CLOX1 and 2 scores (F=5.66, P=.001, and F=4.33, P=.006, respectively).
  
  
  CONCLUSIONS
  Patients undergoing CE for symptomatic LICA disease appear to be at greater risk of cognitive decline than other subjects. These findings suggest that future studies should evaluate the effects on cognitive function of different timing for CE in patients with LICA and RICA disease.
authors.affiliation: Section of Gerontology, Department of Medical and Surgical Disciplines, University of Turin, Ospedale San Giovanni Battista-Molinette, Corso Bramante 88, 10126 Turin, Italy. mario.bo@unito.it
authors.forename: Mario
authors.initials: M
authors.lastname: Bo
authors.forename: Massimiliano
authors.initials: M
authors.lastname: Massaia
authors.forename: Stefania
authors.initials: S
authors.lastname: Speme
authors.forename: Giorgetta
authors.initials: G
authors.lastname: Cappa
authors.forename: Khenya
authors.initials: K
authors.lastname: Strumia
authors.forename: Paolo
authors.initials: P
authors.lastname: Cerrato
authors.forename: Federico
authors.initials: F
authors.lastname: Ponzio
authors.forename: Leone
authors.initials: L
authors.lastname: Poli
mesh_terms: D000368:Aged; D000792:Angiography; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging / Q000473:pathology; D016893:Carotid Stenosis / Q000175:diagnosis / Q000601:surgery; D003072:Cognition Disorders / Q000453:epidemiology / Q000209:etiology*; D016894:Endarterectomy, Carotid / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008279:Magnetic Resonance Imaging; D008297:Male; D019370:Observation; D011183:Postoperative Complications; D011379:Prognosis; D012307:Risk Factors; D018615:Ultrasonography, Doppler, Color