title: Carotid plaque as a predictor of dementia in older adults: the Three-City Study.
abstract: BACKGROUND
  The contribution of carotid atherosclerosis to incident dementia remains unclear. We examined the association between carotid plaques (CP) and common carotid intima media thickness (CCA-IMT) with incident dementia and its subtypes, and their added value for dementia risk prediction.
  
  
  METHODS
  At baseline, 6025 dementia-free subjects aged 65-86 years underwent bilateral carotid ultrasonography measures of CP and plaque-free CCA-IMT. Subjects were followed-up over 7 years for the detection of dementia.
  
  
  RESULTS
  After a mean 5.4 years of follow-up, 421 subjects developed dementia including 272 Alzheimer's disease and 83 vascular/mixed dementia (VaD). Only CP were independently related to VaD (HR(≥2 sites with plaques) = 1.92; 95% confidence interval or CI = 1.13-3.22) and improved VaD risk prediction (continuous Net Reclassification Index = 30.1%; 95% CI = 8.4-51.7) beyond known dementia risk factors. Accounting for stroke or competing risk by death marginally modified the results.
  
  
  CONCLUSIONS
  In older adults, CP are independent predictors of incident VaD and may improve VaD risk prediction.
authors.affiliation: Inserm, CESP Centre for Research in Epidemiology and Population Health, UMR-S1018, Hormones and Cardiovascular Disease, University Paris Sud, Villejuif, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Carcaillon
authors.affiliation: Inserm, UMR-S 970, Paris Descartes University, Sorbonne Paris Cité, Paris Cardiovascular Research Center, Paris, France; Assistance Publique - Hôpitaux de Paris, Hôpital Broca, Paris, France. Electronic address: matthieu.plichart@inserm.fr.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Plichart
authors.affiliation: Inserm U700, Paris, France.
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Zureik
authors.affiliation: CMMR CHU Dijon, Dijon, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Rouaud
authors.affiliation: Inserm, UMR-S 970, Paris Descartes University, Sorbonne Paris Cité, Paris Cardiovascular Research Center, Paris, France; Epidemiology and Clinical Research Unit, Arras General Hospital, Arras, France.
authors.forename: Bilal
authors.initials: B
authors.lastname: Majed
authors.affiliation: Inserm U1061, Neuropsychiatry: Epidemiological and Clinical Research, Hôpital La Colombière, Montpellier, France; Imperial College, Faculty of Medicine, London, United Kingdom; University of Montpellier 1, Faculty of Medicine, Montpellier, France.
authors.forename: Karen
authors.initials: K
authors.lastname: Ritchie
authors.affiliation: Inserm U708, Neuroepidemiology, Bordeaux, France; University of Victor Segalen Bordeaux2, Bordeaux, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Tzourio
authors.affiliation: University of Victor Segalen Bordeaux2, Bordeaux, France; Inserm U897, Epidemiology and Neuropsychology of Brain Aging, Bordeaux, France.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Dartigues
authors.affiliation: Inserm, UMR-S 970, Paris Descartes University, Sorbonne Paris Cité, Paris Cardiovascular Research Center, Paris, France.
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Empana
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology; D059168:Carotid Intima-Media Thickness; D003704:Dementia / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011379:Prognosis; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors; D012680:Sensitivity and Specificity
keywords: Aging; Atherosclerosis; Dementia; Epidemiology; Risk factors