Subclinical carotid atherosclerosis and neurocognitive function in an urban population.
Examine age, sex, race, and socioeconomic status as modifiers of the association between carotid intimal medial thickness (IMT) and neurocognitive performance in a socioeconomically diverse, biracial, urban, adult population.



Participants were 1712 community-dwelling adults (45% men, 56% African-American, 38% below poverty threshold, aged 30-64 years) enrolled in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study. Participants underwent initial carotid ultrasonography followed by cognitive testing on up to two occasions over 4 years. Mixed-effects regression analyses were adjusted for demographic, behavioral, and biomedical covariates.



Significant cross-sectional IMT × race × poverty interactions were identified for measures of delayed recall memory, auditory-verbal attention, and working memory. An IMT × race interaction also appeared for auditory-verbal learning. Higher IMT was generally associated with worse cognitive performance, but the disadvantage was most pronounced among those with higher socioeconomic status and white participants. No longitudinal associations were identified.



Carotid IMT-cognition associations differed as a function of race and socioeconomic status and were most compelling for measures of attention, executive function, and memory. These findings highlight the possibility that subclinical atherosclerosis may be differentially informative as a predictor of cognitive performance among varied demographic subgroups.
Department of Psychology, University of Maryland, Baltimore County, USA; Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, NIH, USA. Electronic address: crwendell@umbc.edu.
Carrington R
CR
Wendell
Department of Psychology, University of Maryland, Baltimore County, USA; Division of Gerontology & Geriatric Medicine, Department of Medicine, University of Maryland School of Medicine, USA; Geriatric Research Education and Clinical Center, Baltimore VA Medical Center, USA.
Shari R
SR
Waldstein
Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, NIH, USA.
Michele K
MK
Evans
Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, NIH, USA.
Alan B
AB
Zonderman
D000328:Adult; D001741:Black or African American; D050197:Atherosclerosis / Q000453:epidemiology; D001288:Attention; D015142:Baltimore; D002340:Carotid Artery Diseases / Q000150:complications / Q000175:diagnosis* / Q000208:ethnology; D059168:Carotid Intima-Media Thickness; D003071:Cognition; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis* / Q000208:ethnology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008568:Memory; D008875:Middle Aged; D011203:Poverty; D011446:Prospective Studies; D012044:Regression Analysis; D012923:Social Class; D014505:Urban Population; D044465:White People
Carotid intimal medial thickness; Cognitive function; Subclinical cardiovascular disease