Risk of cognitive decline in older patients after carotid endarterectomy: an observational study.
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.
Bo
Mario
M
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
Massaia
Massimiliano
M
Speme
Stefania
S
Cappa
Giorgetta
G
Strumia
Khenya
K
Cerrato
Paolo
P
Ponzio
Federico
F
Poli
Leone
L
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