title: Atherosclerotic calcification is related to a higher risk of dementia and cognitive decline.
abstract: BACKGROUND
  Longitudinal data on the role of atherosclerosis in different vessel beds in the etiology of cognitive impairment and dementia are scarce and inconsistent.
  
  
  METHODS
  Between 2003-2006, 2364 nondemented persons underwent computed tomography of the coronaries, aortic arch, extracranial, and intracranial carotid arteries to quantify atherosclerotic calcification. Participants were followed for incident dementia (n = 90) until April 2012. At baseline and follow-up participants also underwent a cognitive test battery.
  
  
  RESULTS
  Larger calcification volume in all vessels, except in the coronaries, was associated with a higher risk of dementia. After adjustment for relevant confounders, extracranial carotid artery calcification remained significantly associated with a higher risk of dementia [hazard ratio per standard deviation increase in calcification volume: 1.37 (1.05, 1.79)]. Additional analyses for Alzheimer's disease only or censoring for stroke showed similar results. Larger calcification volumes were also associated with cognitive decline.
  
  
  CONCLUSIONS
  Atherosclerosis, in particular in the extracranial carotid arteries, is related to a higher risk of dementia and cognitive decline.
authors.affiliation: Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Daniel
authors.initials: D
authors.lastname: Bos
authors.affiliation: Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Meike W
authors.initials: MW
authors.lastname: Vernooij
authors.affiliation: Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Renée F A G
authors.initials: RF
authors.lastname: de Bruijn
authors.affiliation: Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Koudstaal
authors.affiliation: Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.affiliation: Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Oscar H
authors.initials: OH
authors.lastname: Franco
authors.affiliation: Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Aad
authors.initials: A
authors.lastname: van der Lugt
authors.affiliation: Department of Radiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands; Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands. Electronic address: m.a.ikram@erasmusmc.nl.
authors.forename: M Arfan
authors.initials: MA
authors.lastname: Ikram
mesh_terms: D000368:Aged; D001013:Aorta, Thoracic / Q000000981:diagnostic imaging; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000523:psychology; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000523:psychology; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D003072:Cognition Disorders / Q000000981:diagnostic imaging / Q000453:epidemiology*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D003704:Dementia / Q000000981:diagnostic imaging / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D011446:Prospective Studies; D012306:Risk; D020521:Stroke / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000523:psychology; D014057:Tomography, X-Ray Computed
keywords: Arterial calcification; Atherosclerosis; Cognitive decline; Dementia; Epidemiology; Imaging