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Carotid atherosclerosis and prospective risk of dementia.

Publication ,  Journal Article
Wendell, CR; Waldstein, SR; Ferrucci, L; O'Brien, RJ; Strait, JB; Zonderman, AB
Published in: Stroke
December 2012

BACKGROUND AND PURPOSE: Although vascular risk factors have been implicated in the development of all-cause dementia and Alzheimer disease (AD), few studies have examined the association between subclinical atherosclerosis and prospective risk of dementia. METHODS: Participants from the Baltimore Longitudinal Study of Aging (n=364; age, 60-95 years; median age, 73; 60% male; 82% white) underwent initial carotid atherosclerosis assessment and subsequently were assessed for dementia and AD annually for up to 14 years (median, 7.0). Cox proportional hazards models predicting all-cause dementia and AD were adjusted for age, sex, race, education, blood pressure, cholesterol, cardiovascular disease, diabetes mellitus, and smoking. RESULTS: Sixty participants developed dementia, with 53 diagnosed as AD. Raw rates of future dementia and AD among individuals initially in the upper quintile of carotid intimal medial thickness or with bilateral carotid plaque were generally double the rates of individuals with intimal medial thickness in the lower quintiles or no plaque at baseline. Adjusted proportional hazards models revealed >2.5-fold increased risk of dementia and AD among individuals in the upper quintile of carotid intimal medial thickness, and approximately 2.0-fold increased risk of dementia among individuals with bilateral plaque. CONCLUSIONS: Multiple measures of carotid atherosclerosis are associated with prospective risk of dementia. Individuals in the upper quintile of carotid intimal medial thickness or bilateral carotid plaque were at greatest risk. These findings underscore the possibility that early intervention to reduce atherosclerosis may help delay or prevent onset of dementia and AD.

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Published In

Stroke

DOI

EISSN

1524-4628

Publication Date

December 2012

Volume

43

Issue

12

Start / End Page

3319 / 3324

Location

United States

Related Subject Headings

  • Severity of Illness Index
  • Risk Factors
  • Prospective Studies
  • Proportional Hazards Models
  • Predictive Value of Tests
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Longitudinal Studies
  • Incidence
 

Citation

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Wendell, C. R., Waldstein, S. R., Ferrucci, L., O’Brien, R. J., Strait, J. B., & Zonderman, A. B. (2012). Carotid atherosclerosis and prospective risk of dementia. Stroke, 43(12), 3319–3324. https://doi.org/10.1161/STROKEAHA.112.672527
Wendell, Carrington R., Shari R. Waldstein, Luigi Ferrucci, Richard J. O’Brien, James B. Strait, and Alan B. Zonderman. “Carotid atherosclerosis and prospective risk of dementia.Stroke 43, no. 12 (December 2012): 3319–24. https://doi.org/10.1161/STROKEAHA.112.672527.
Wendell CR, Waldstein SR, Ferrucci L, O’Brien RJ, Strait JB, Zonderman AB. Carotid atherosclerosis and prospective risk of dementia. Stroke. 2012 Dec;43(12):3319–24.
Wendell, Carrington R., et al. “Carotid atherosclerosis and prospective risk of dementia.Stroke, vol. 43, no. 12, Dec. 2012, pp. 3319–24. Pubmed, doi:10.1161/STROKEAHA.112.672527.
Wendell CR, Waldstein SR, Ferrucci L, O’Brien RJ, Strait JB, Zonderman AB. Carotid atherosclerosis and prospective risk of dementia. Stroke. 2012 Dec;43(12):3319–3324.

Published In

Stroke

DOI

EISSN

1524-4628

Publication Date

December 2012

Volume

43

Issue

12

Start / End Page

3319 / 3324

Location

United States

Related Subject Headings

  • Severity of Illness Index
  • Risk Factors
  • Prospective Studies
  • Proportional Hazards Models
  • Predictive Value of Tests
  • Neurology & Neurosurgery
  • Middle Aged
  • Male
  • Longitudinal Studies
  • Incidence